A Rare Clinical Presentation Due to Small Cortical Infarction: Isolated Wrist Drop

Abstract

Isolated wrist drop due to stroke is infrequently observed, and often misdiagnosed as peripheral neuropathy. It is important to make the differential diagnosis correctly because drop hand that results from peripheral pathology requires a completely different treatment strategy than central pathology. In addition, small infarcts are important to identify in order to optimise secondary prophylaxis. In this report, we describe an 83-year-old man, with isolated drop hand due to acute small cortical infarction in the left precentral gyrus and present this situation in light of the literature. Key Words: Isolated wrist drop, cortical infarction, precentral gyrus. KÜÇÜK KORTİKAL İNFARKTA BAĞLI NADİR GÖRÜLEN BİR KLİNİK TABLO: İZOLE DÜŞÜK EL ÖZETSerebrovasküler olaylara bağlı gelişen izole düşük el tablosu oldukça nadir görülür ve genellikle periferik sinir lezyonları şeklinde yanlış tanı alır. Tedavi stratejileri tamamen farklı olan santral ve periferik patolojilere bağlı gelişen düşük el ayırıcı tanısı oldukça önmelidir. Ayrıca küçük kortikal infarktların tanınması, özellikle sekonder proflaksi açısından önemlidir. Bu vaka takdiminde, 83 yaşında erkek hasta küçük kortikal infarkt nedeni ile gelişen izole düşük el tanısı ile literature ışığında sunulmuştur. Anahtar Sözcükler: İzole düşük el, kortikal infarkt, presentral girus.

Isolated Wrist Drop Presenting as Acute Stroke: Rare Case Report with Review of Literature

“…Isolated unilateral wrist drop is often misdiagnosed as peripheral nerve palsies. It is important to keep differential diagnosis of acute stroke in mind to [1] An 83-year-old male with isolated right wrist drop Hypertension, Type 2 diabetes, hyperlipidemia, and ischemic heart disease Infarct at the left precentral gyrus Takahashi et al [4] Five patients having monoparesis with radial type hand palsy Not known Infarct at middle-to-lower portion of the anterior wall of the central sulcus Timsit et al [5] Six patients with evolving hand palsy (pseudo ulnar type) Hypertension (4), cigarette (4), hypercholesterolemia (3), and history of angina pectoris (1) Inferior parietal lobule infarct…”

“…As the patient was at higher risk for stroke, it was considered as one of the diagnoses and evaluations done. [1] Embolic stroke of the hand knob area or small lacunar infarct is considered as one of the causes for unilateral wrist drop. [1] It has been reported by Kim that ulnar-like deficits are associated with severe stenosis or occlusion of the carotid artery, whereas radial-like deficits are associated with an embolic mechanism.…”

“…[1] Embolic stroke of the hand knob area or small lacunar infarct is considered as one of the causes for unilateral wrist drop. [1] It has been reported by Kim that ulnar-like deficits are associated with severe stenosis or occlusion of the carotid artery, whereas radial-like deficits are associated with an embolic mechanism. [2] Our patient was not having any significant primary diagnosis, but it was presumed to be silent emboli stroke.…”

Isolated Wrist Drop as the Sole Presentation of an Acute Embolic Ischemic Stroke

“…Wrist drop refers to the inability to extend the wrist, which occurs due to weakness of the wrist extensor muscle groups innervated by the radial nerve or its branches. Most cases develop due to peripheral neurovascular, neuromuscular, and musculoskeletal causes; however, rare causes of central wrist drop have been reported in the literature [1,[3][4][5][6][7][8].…”