Open AccessFractional arm weakness as presentation of stroke due to posterior borderzone infarct: A report of two cases
Author(s) -
Kaukab Maqbool Hassan
Publication year - 2010
Publication title -
annals of indian academy of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.427
H-Index - 31
eISSN - 1998-3549
pISSN - 0972-2327
DOI - 10.4103/0972-2327.74196
Subject(s) - medicine , weakness , radiology , posterior cerebral artery , magnetic resonance imaging , stroke (engine) , magnetic resonance angiography , digital subtraction angiography , internal carotid artery , stenosis , infarction , carotid endarterectomy , angiography , middle cerebral artery , cardiology , myocardial infarction , surgery , ischemia , mechanical engineering , engineering
A 41-year-old male presented with acute onset weakness of the left hand. Magnetic resonance imaging (MRI) of the brain showed hyperacute infarct in the right middle cerebral artery (MCA)-posterior cerebral artery (PCA) watershed territory. Magnetic resonance angiography (MRA), Doppler ultrasonography, and digital subtraction angiography revealed severe right internal carotid artery (ICA) stenosis. The patient underwent carotid endarterectomy. The second patient was a 48-year-old male with acute onset right wrist drop. MRI of brain showed acute infarct in the left MCA-PCA watershed territory. MRA of brain and neck, Doppler ultrasonography of the neck vessels, and echocardiography were normal. Both the cases were not initially considered strokes by the referring physicians. Isolated hand palsy is a rare presentation of stroke, often mistaken for peripheral lesion. Fractional limb weakness as a presentation of acute ischemic stroke due to borderzone infarction involving parietal lobe is a rarely reported entity.