Celebisoy Mehmet, Ozdemirkiran Tolga, Tokucoglu Figen, Kaplangi Derya N, Arici Sehnaz
Department of Neurology, Atatürk Training and Research Hospital, Izmir, Turkey.
Neurologist. 2007 Nov;13(6):376-9. doi: 10.1097/NRL.0b013e31814db093.
To evaluate the cortical presentation of the hand area according to MRI images of the infarcted area in patients who have predominantly hand weakness.
"Pseudoperipheral palsy" is an old term employed to describe a rare clinical picture consisting of predominant weakness of the hand in association with cerebral infarction. Because the organization of the cortical efferent area of the hand has not been fully defined, this phenomenon merits attention. Recent advances in functional imaging have stimulated renewed interest in the cortical mapping of various body parts, particularly that of the hand.
The patients who had isolated hand palsy due to cerebral infarction underwent clinical examination and cerebral MRI investigation to locate the exact lesion site.
Eight patients (6 men, 2 women) aged 55 to 80 years (mean 69 years) were included in this study. All had at least one risk factor for cerebrovascular disease. All our 8 patients presented with hand palsy and lesions were detected in the contralateral precentral gyrus in all cases. The lesions were located in the middle to lower portion of the anterior wall of the central sulcus just posterior to the intersection of the superior frontal and precentral sulci.
Our findings indicate that the hand area in the cerebral motor cortex is located in the middle to lower portion of the anterior wall of the central sulcus, that is, in Brodmann area 4. We present our 8 patients showing isolated hand palsy due to a discrete cortical infarction on MRI to expand the knowledge about cortical localization of the hand area.
根据主要表现为手部无力的患者梗死区域的MRI图像，评估手部区域的皮质表现。
“假性周围性麻痹”是一个旧术语，用于描述一种罕见的临床情况，即与脑梗死相关的主要手部无力。由于手部皮质传出区域的组织尚未完全明确，这种现象值得关注。功能成像的最新进展激发了人们对各种身体部位皮质映射的新兴趣，尤其是手部。
对因脑梗死导致孤立性手部麻痹的患者进行临床检查和脑部MRI检查，以确定确切的病变部位。
本研究纳入了8例年龄在55至80岁（平均69岁）的患者（6例男性，2例女性）。所有患者至少有一个脑血管疾病危险因素。我们的8例患者均表现为手部麻痹，所有病例在对侧中央前回均检测到病变。病变位于中央沟前壁的中下部，恰好在额上沟与中央前沟交点的后方。
我们的研究结果表明，大脑运动皮质中的手部区域位于中央沟前壁的中下部，即布罗德曼第4区。我们展示了8例因MRI上离散的皮质梗死而出现孤立性手部麻痹的患者，以扩展关于手部区域皮质定位的知识。
