Hassan Kaukab Maqbool
Department of Neurology, Command Hospital & Armed Forces Medical College, Pune.
Ann Indian Acad Neurol. 2010 Oct;13(4):302-4. doi: 10.4103/0972-2327.74196.
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.
一名41岁男性因左手急性无力就诊。脑部磁共振成像（MRI）显示右侧大脑中动脉（MCA）-大脑后动脉（PCA）分水岭区域存在超急性梗死灶。磁共振血管造影（MRA）、多普勒超声检查及数字减影血管造影显示右侧颈内动脉（ICA）严重狭窄。该患者接受了颈动脉内膜切除术。第二例患者为一名48岁男性，急性起病，出现右手垂腕。脑部MRI显示左侧MCA-PCA分水岭区域急性梗死灶。脑部及颈部MRA、颈部血管多普勒超声检查及超声心动图均正常。两位患者最初均未被转诊医生视为中风。孤立性手部麻痹是中风的一种罕见表现，常被误诊为周围性病变。因顶叶边缘带梗死导致的部分肢体无力作为急性缺血性中风的一种表现是一种鲜有报道的情况。
