Ann Rehabil Med.  2017 Aug;41(4):715-719. 10.5535/arm.2017.41.4.715.

Common Peroneal Neuropathy With Anterior Tibial Artery Occlusion: A Case Report

• Jeon S
• Kim DY
• Shim DJ
• Kim MW

• KMID: 2389420
• DOI: http://doi.org/10.5535/arm.2017.41.4.715

Abstract

Peroneal neuropathy is a common mononeuropathy of the lower limb. Some studies have reported cases of peroneal neuropathy after vascular surgery or intervention. However, no cases of peroneal neuropathy with occlusion of a single peripheral artery have been previously reported. A 73-year-old man was referred with a 3-week history of left-sided foot drop. He had a history of valvular heart disease and arrhythmia, and had previously been treated with percutaneous coronary intervention. Computed tomography angiogram of the lower extremity showed proximal occlusion of the left anterior tibial artery. An electrodiagnostic study confirmed left common peroneal neuropathy. After diagnosis, anticoagulation therapy was started and he received physical therapy.

Keyword

Peroneal neuropathies; Tibial arteries; Ischemia

MeSH Terms

Aged
Arrhythmias, Cardiac
Arteries
Diagnosis
Foot
Heart Valve Diseases
Humans
Ischemia
Lower Extremity
Mononeuropathies
Percutaneous Coronary Intervention
Peroneal Neuropathies*
Tibial Arteries*

Figure

• 

  Fig. 1 Computed tomography angiography of the lower extremities. (A) An axial image showing proximal occlusion of the left anterior tibial artery (arrow). (B, C, D) Three-dimensional reconstruction images demonstrate the left anterior tibial artery occlusion at the level of the fibular neck (arrow).

• 

  Fig. 2 Vascular supply of common peroneal nerve (arrow head, occlusion level).

Reference

1. Aprile I, Caliandro P, La Torre G, Tonali P, Foschini M, Mondelli M, et al. Multicenter study of peroneal mononeuropathy: clinical, neurophysiologic, and quality of life assessment. J Peripher Nerv Syst. 2005; 10:259–268. PMID: 16221285.

2. Okada K, Sueda T, Shikata H, Orihashi K, Morita S, Hirai S, et al. Evoked spinal cord potential monitoring reveals peroneal nerve ischemia during thoracoabdominal repair: a case report. Ann Thorac Cardiovasc Surg. 1999; 5:350–352. PMID: 10550725.

3. Sprowson AP, Rankin K, Shand JE, Ferrier G. Common peroneal and posterior tibial ischemic nerve damage, a rare cause. Foot Ankle Surg. 2010; 16:e16–e17. PMID: 20483119.

4. Giannakopoulou C, Korakaki E, Hatzidaki E, Manoura A, Aligizakis A, Velivasakis E. Peroneal nerve palsy: a complication of umbilical artery catheterization in the full-term newborn of a mother with diabetes. Pediatrics. 2002; 109:e66. PMID: 11927739.

5. Ugrenovic SZ, Jovanovic ID, Kovacevic P, Petrović S, Simic T. Similarities and dissimilarities of the blood supplies of the human sciatic, tibial, and common peroneal nerves. Clin Anat. 2013; 26:875–882. PMID: 23280564.

6. Kadiyala RK, Ramirez A, Taylor AE, Saltzman CL, Cassell MD. The blood supply of the common peroneal nerve in the popliteal fossa. J Bone Joint Surg Br. 2005; 87:337–342. PMID: 15773642.

7. Ryan W, Mahony N, Delaney M, O'Brien M, Murray P. Relationship of the common peroneal nerve and its branches to the head and neck of the fibula. Clin Anat. 2003; 16:501–505. PMID: 14566896.

8. Eguchi K, Majima M. Sciatic neuropathy caused by disorder of a nutrient artery: a case report of thromboembolism secondary to profunda femoral artery aneurysm. Arch Phys Med Rehabil. 2001; 82:253–255. PMID: 11239320.

9. McDermott MM, Sufit R, Nishida T, Guralnik JM, Ferrucci L, Tian L, et al. Lower extremity nerve function in patients with lower extremity ischemia. Arch Intern Med. 2006; 166:1986–1992. PMID: 17030832.

10. Machacek J, Machacek F. Unusual cause of the peroneal nerve paralysis (Contribution on the “syndrome of the anterior tibial artery”). Z Orthop Ihre Grenzgeb. 1966; 102:317–321. PMID: 4385147.