Ipsilateral hemiparesis in ischemic stroke patients

Inatomi, Yuichiro; Nakajima, Makoto; Yonehara, Toshiro; Ando, Yumiko

doi:10.1111/ane.12690

Cited by 23 publications

(26 citation statements)

References 27 publications

(62 reference statements)

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“…Consistent with previous studies [5, 11], most patients in our study (72.7%, N = 16) showed history of stroke and it caused limb paralysis contralateral to responsible lesions. Besides that, previous strokes were contralateral to the side of the recent stroke in 14 out of 16 patients (87.5%), suggesting that recurrent deficit occurring in the same limb from previous stroke in those cases, and past strokes or brain injury contralateral to recent strokes might be associated with the pathogenesis of motor deficits ipsilateral to recent lesions.…”

Section: Discussionsupporting

confidence: 93%

“…In our study, most cases demonstrated small patchy lesions (Fig. 1), and the recent responsible lesions located along pyramidal tract, which is consistent with findings of previous studies [5]. However, only patient 3 shows bilateral hemiparesis due to unilateral stroke, no obvious motor deficits contralateral to infarct were observed in the other 21 cases.…”

Section: Discussionsupporting

confidence: 92%

“…Almost all patients with supratentorial stroke involving the pyramidal tract exhibit contralateral motor dysfunction. Conversely, more and more cases of ipsilateral stoke or deterioration of hemiparesis ipsilateral to the cerebral injury are reported [1–4], One previous study focused on ipsilateral hemiparesis in ischemic stroke patients found a high proportion of history of stroke contralateral to the recent stroke in cases of ipsilateral hemiparesis [5], which indicating the need to investigate unusual ipsilateral stroke for exploring the mechanism of post-stroke compensatory motor function, such as the enhanced pyramidal tract [1, 6]. increased cerebral blood flow [7, 8] and increased activation of motor regions [9, 10] in unaffected hemisphere after stroke.…”

Section: Introductionmentioning

confidence: 99%

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Spectrum of clinical features and neuroimaging findings in acute cerebral infarction patients with unusual ipsilateral motor impairment– a series of 22 cases

2019

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BackgroundCerebral infarction occurs when the arteries to brain are obstructed, and motor impairment contralateral to responsible lesion is commonly recognized. Few studies have profiled the characteristics of cases with ipsilateral motor impairment. We sought to characterize clinical features of patients with motor dysfunction caused by ipsilateral ischemic stroke.MethodsWe retrieved and analyzed the medical data for patients with ipsilateral cerebral infarction. Patients were regarded as having ipsilateral cerebral infarction if motor impairment is ipsilateral to recent stroke lesions.ResultsOnly 22 patients with unusual ipsilateral cerebral infarction were included in this study. Ipsilateral limb paralysis was observed in all cases, and one case showed central facioplegia. Majority of patients with limb paralysis (90.9%, 20/22) presented with mild muscle strength deficits (MRC grading of 4 or more). Most of the patients (72.7%, 16/22) had a past history of stroke, and previous strokes were contralateral to the side of the recent stroke in 14 out of 16 patients (87.5%). No history of stroke or cerebral injury was identified in seven patients. With aspect of MRI findings, recent infarct lesions of all cases were located along the corticospinal tract.ConclusionsHistory of stroke plays an important role in the pathogenesis of ipsilateral motor impairment, and cortical reorganization in the unaffected hemisphere may contribute to the compensation of motor function after stroke. Besides that, some cases with first stroke may be due to impairment of ipsilateral uncrossed corticospinal fibers.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

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Spectrum of clinical features and neuroimaging findings in acute cerebral infarction patients with unusual ipsilateral motor impairment– a series of 22 cases

2019

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“…Ipsilateral hemiparesis is also reported with previous contralateral infarcts possibly from disruption of compensating normal uncrossed corticospinal fibres. 2 This patient has no baseline impairment and demonstrates nondecussating tracts as an anatomical variant.…”

mentioning

confidence: 85%

Teaching NeuroImages: Stroke With Nondecussating Corticospinal Tracts Causing Ipsilateral Weakness

2021

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“…Demirtastatlidede et al 2015 [46] explicated that 1-Hz rTMS in the affected contralesional hemisphere may help transform the neuroplasticity of patients with severe chronic stroke. LF-rTMS-enhanced exercise training could improve the dyspraxia of patients with severe upper limb dyspraxia after a chronic stroke [47].…”

Section: Rtms On Motor-function Recovery After Chronic Strokementioning

confidence: 99%

Promotion of Poststroke Motor-Function Recovery with Repetitive Transcranial Magnetic Stimulation by Regulating the Interhemispheric Imbalance

et al. 2020

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Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive brain-stimulation technique that transiently modulates cerebral cortex excitability, achieving overall positive results in poststroke motor-function recovery. Excessive inhibition of the ipsilesional-affected hemisphere by the contralesional-unaffected hemisphere has seriously hindered poststroke motor-function recovery. Hence, intracortical disinhibition can be used as an approach to managing poststroke brain injury. This technique promotes neural plasticity for faster motor-function recovery. rTMS relieves unilateral inhibition of the brain function by regulatinga interhemispheric-imbalanced inhibition. This paper summarized 12 studies from 2016 to date, focusing on rTMS on motor function after acute and chronic stroke by regulating the interhemispheric imbalance of inhibitory inputs. Although rTMS studies have shown promising outcomes on recovery of motor functions in stroke patients, different intervention methods may lead to discrepancies in results. A uniform optimal stimulus model cannot routinely be used, mainly due to the stimulus schemes, stroke types and outcome-measuring differences among studies. Thus, the effect of rTMS on poststroke motor-function recovery should be investigated further to standardize the rTMS program for optimal poststroke motor-function recovery. More randomized, placebo-controlled clinical trials with standardized rTMS protocols are needed to ensure the effectiveness of the treatment.

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Ipsilateral hemiparesis in ischemic stroke patients

Cited by 23 publications

References 27 publications

Spectrum of clinical features and neuroimaging findings in acute cerebral infarction patients with unusual ipsilateral motor impairment– a series of 22 cases

Spectrum of clinical features and neuroimaging findings in acute cerebral infarction patients with unusual ipsilateral motor impairment– a series of 22 cases

Teaching NeuroImages: Stroke With Nondecussating Corticospinal Tracts Causing Ipsilateral Weakness

Promotion of Poststroke Motor-Function Recovery with Repetitive Transcranial Magnetic Stimulation by Regulating the Interhemispheric Imbalance

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