Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, No. 8 Gongtinan Road, Chaoyang District, Beijing, 100020, China.
Neurol Sci. 2018 May;39(5):857-862. doi: 10.1007/s10072-018-3278-5. Epub 2018 Feb 17.
Hand knob infarction (HKI) is a rare clinical condition which is often misdiagnosed as peripheral neuropathy. This study aimed to identify the clinical characteristics and risk factors of HKI. Nine HKI patients admitted between January 2013 and March 2016 were confirmed by magnetic resonance imaging. Their medical records were collected and analyzed. The modified Rankin Scale was used to assess clinical outcomes. Routine laboratory tests, electrocardiogram, echocardiography, cranial magnetic resonance imaging, magnetic resonance angiography, computed tomography angiography, and Doppler ultrasonography examinations were performed. Seven patients had uniform involvement of all digits. One patient with radial weakness had a lesion in the lateral area of hand knob, and another patient with ulnar weakness had a lesion distributed in the medial area of hand knob. Hyperhomocysteinemia was a most common risk factor for HKI. Most HKI patients had a benign disease course, but three patients (33.33%) with the stroke type of large artery atherosclerosis had disease recurrence. We characterized clinical characteristics and risk factors of HKI which will help the diagnosis and management of HKI.
手球梗死（HKI）是一种罕见的临床病症，常被误诊为周围神经病。本研究旨在确定 HKI 的临床特征和危险因素。2013 年 1 月至 2016 年 3 月间，9 例 HKI 患者经磁共振成像确诊。收集并分析其病历资料。采用改良 Rankin 量表评估临床结局。进行常规实验室检查、心电图、超声心动图、颅脑磁共振成像、磁共振血管成像、计算机断层血管成像和多普勒超声检查。7 例患者所有手指均呈均匀受累。1 例桡侧无力患者在手球外侧区域存在病变，另 1 例尺侧无力患者在手球内侧区域存在病变。高同型半胱氨酸血症是 HKI 的最常见危险因素。大多数 HKI 患者的病程呈良性，但 3 例（33.33%）大动脉硬化性脑卒中患者出现疾病复发。我们描述了 HKI 的临床特征和危险因素，有助于 HKI 的诊断和治疗。
