'Cortical' Wrist Drop due to a Cerebral Peduncle Infarct
| Autor: | Yeow Wai Lim, Amogh Narayan Hegde, Narayanaswamy Venketasubramanian |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Infarction
Wrist lcsh:RC346-429 03 medical and health sciences 0302 clinical medicine medicine infarct cardiovascular diseases 030212 general & internal medicine Stroke lcsh:Neurology. Diseases of the nervous system Radial nerve cerebral peduncle medicine.diagnostic_test business.industry Cerebral peduncle Anatomy medicine.disease stroke wrist drop Small Vessel Disease body regions Peripheral neuropathy medicine.anatomical_structure Nerve conduction study Neurology (clinical) business 030217 neurology & neurosurgery Wrist drop |
| Zdroj: | Case Rep Neurol Case Reports in Neurology, Vol 12, Iss 1, Pp 207-211 (2020) |
| ISSN: | 1662-680X |
| DOI: | 10.1159/000504128 |
| Popis: | Wrist drops are usually due to a peripheral neuropathy affecting the radial nerve. Cortical wrist drops may occur, usually due to a lesion in the contralateral hand area of the motor cortex. We report a unique case of “cortical” wrist drop due to an acute infarction of the contralateral cerebral peduncle. The patient is a 70-year-old gentleman with the vascular factors of hypertension, hyperlipidaemia, and prior cerebellar strokes, who developed sudden onset of right wrist weakness without numbness. Neurological examination showed a right wrist and finger drop. Nerve conduction study of the radial nerve was normal. MRI brain revealed an acute infarct in the medial part of the left cerebral peduncle, extending slightly to the medial thalamus; there were also old medial posterior cerebellar infarcts. Time of flight MR angiography was normal, with hypoplastic right vertebral artery. Echocardiography was normal but for a dilated right atrium. Electrocardiogram was normal, and 24-hour Holter monitoring detected infrequent atrial and ventricular ectopics. X-ray wrist showed an old ulnar styloid fracture. Nerve conduction study of the radial nerve was normal. He was switched from aspirin to clopidogrel and underwent rehabilitation. The cerebral peduncle should not be forgotten when attempting to anatomically localise the site of the lesion when evaluating a patient with a wrist drop. |
| Databáze: | OpenAIRE |
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