Péter Orosz1, Ildikó Szőcs2, Gábor Rudas3, András Folyovich4, Dániel Bereczki2, Ildikó Vastagh2. 1. Department of Neurology, Semmelweis University, Budapest, Hungary. Electronic address: dr.oroszpeter@gmail.com. 2. Department of Neurology, Semmelweis University, Budapest, Hungary. 3. MR Research Center, Semmelweis University, Budapest, Hungary. 4. Department of Neurology, Szent János Hospital, Budapest, Hungary.
Abstract
BACKGROUND: Although uncommon, cortical hand knob territory stroke is a well-defined stroke entity that mimics peripheral nerve damage. Atherosclerosis and hypertension are the most prevalent risk factors for the disease. Embolic origin, either artery-to-artery or cardioembolic, has been suggested as the most probable underlying mechanism. MATERIALS AND METHODS: Twenty-five patients with isolated hand palsy due to central origin were admitted to our department between 2006 and 2016. Cortical lesions were proven by either computed tomography or magnetic resonance imaging. RESULTS: The average age was 67 ± 12 years. Most of the cases were first-ever strokes (n = 23, 92%). Isolated infarct in the hand knob region was found in 18 of the 25 cases, whereas 7 had multiple acute infarctions. Supra-aortic atherosclerosis was found in 21 patients, 8 of them had 50% or greater ipsilateral stenosis of the internal carotid artery. Hypertension was the second most prevalent risk factor (n = 20, 80%). Quick improvement of symptoms was seen in almost every case (mean follow-up 17.5 months), 9 patients showed complete recovery, whereas 2 remained disabled and 1 died due to a malignant disease. Three patients suffered a recurrent stroke on follow-up. CONCLUSIONS: We conclude that distal arm paresis is a rare presentation of acute stroke with usually benign course.
BACKGROUND: Although uncommon, cortical hand knob territory stroke is a well-defined stroke entity that mimics peripheral nerve damage. Atherosclerosis and hypertension are the most prevalent risk factors for the disease. Embolic origin, either artery-to-artery or cardioembolic, has been suggested as the most probable underlying mechanism. MATERIALS AND METHODS: Twenty-five patients with isolated hand palsy due to central origin were admitted to our department between 2006 and 2016. Cortical lesions were proven by either computed tomography or magnetic resonance imaging. RESULTS: The average age was 67 ± 12 years. Most of the cases were first-ever strokes (n = 23, 92%). Isolated infarct in the hand knob region was found in 18 of the 25 cases, whereas 7 had multiple acute infarctions. Supra-aortic atherosclerosis was found in 21 patients, 8 of them had 50% or greater ipsilateral stenosis of the internal carotid artery. Hypertension was the second most prevalent risk factor (n = 20, 80%). Quick improvement of symptoms was seen in almost every case (mean follow-up 17.5 months), 9 patients showed complete recovery, whereas 2 remained disabled and 1 died due to a malignant disease. Three patients suffered a recurrent stroke on follow-up. CONCLUSIONS: We conclude that distal arm paresis is a rare presentation of acute stroke with usually benign course.
Authors: Paola Nicolini; Andrea Arighi; Elisa Gherbesi; Francesco Maria Lo Russo; Clara Mandelli; Giuseppina Schinco; Stefano Carugo; Tiziano Lucchi Journal: Brain Sci Date: 2022-06-13
Authors: András Folyovich; Viktória Varga; György Várallyay; Lajos Kozák; Mária Bakos; Erika Scheidl; Katalin Anna Béres-Molnár; Zita Kajdácsi; Dániel Bereczki Journal: BMC Cancer Date: 2018-10-03 Impact factor: 4.430