A case of sciatica revealing a giant syphilitic aneurysm

One of the most common, and sometimes challenging, conditions in neurological practice is sciatic neuropathy, a sharp pain radiating in the posterior or lateral side of the leg, eventually complicated by motor and sensory deficits. Mechanical causes like a sprain of the lumbar spine and degenerative processes of the disc, disc herniation, and spinal canal stenosis, but also visceral causes like ectopic endometriosis or ovarian cysts, primary or secondary neoplastic conditions of vertebrae, spinal cord or nerve trunks, inflammatory syndromes and infections can potentially be surgically treated. Clinical and instrumental data should guide the clinician in the identification of atypical sciatica where the surgery will have no effect. We report an atypical case of sciatic neuro- pathy revealing a giant iliac artery aneurysm secondary to tertiary sy- philis. We describe a case of a 79-years-old man reporting 3 months right sciatica associated with progressive numbness, followed by weakness of dorsiflexion of the right foot.