Department of Neurology, Beijing Geriatric Hospital, Beijing, China.
BMC Neurol. 2022 Sep 2;22(1):331. doi: 10.1186/s12883-022-02858-0.
Hand knob stroke is a rare clinical disorder frequently misdiagnosed as peripheral neuropathy. The purpose of this study is to recognize this particular type of stroke by analyzing clinical features, etiology, and prognosis.
We enrolled 19 patients with acute hand knob stroke in the Department of Neurology of the Beijing Geriatric Hospital from January 2018 to January 2022, and the clinical and imaging data of the patients during hospitalization and follow-up were collected and summarized.
Acute hand knob stroke accounted for 0.9% of all acute stroke, and ischemic stroke (17 cases, 89.5%) was more than hemorrhagic stroke (2 cases, 10.5%). All patients presented sudden contralateral hand paresis, 12 (63.2%) of them had only isolated hand paralysis, and the location of the lesion corresponded to different finger weakness. The cause of hand knob hemorrhage was hypertension, while the causes of hand knob infarction were mainly small-vessel occlusion (SVO) (35.3%) and large-artery atherosclerosis (LAA) (35.3%), and the rare causes include carotid artery dissection and carotid body tumor. After a median follow-up 13.5 months, the prognosis of 94.7% patients was good, and one patient (5.3%) had recurrent stroke.
Hand knob stroke is a rare stroke with a good prognosis and a low stroke recurrence rate. Ischemic stroke is the predominant type and the main clinical manifestation is hand paresis. The cause of hand knob hemorrhage is hypertensive, while SVO and LAA are the main causes of hand knob infarction, but there are some rare etiologies.
手 knob 卒中是一种罕见的临床疾病，常被误诊为周围神经病。本研究旨在通过分析临床特征、病因和预后来认识这种特殊类型的卒中。
我们在北京老年医院神经内科纳入了 19 例急性手 knob 卒中患者，收集并总结了患者住院期间及随访的临床及影像学资料。
急性手 knob 卒中占所有急性卒中的 0.9%，缺血性卒中（17 例，89.5%）多于出血性卒中（2 例，10.5%）。所有患者均表现为突发性对侧手部无力，12 例（63.2%）患者仅表现为孤立性手部瘫痪，病变部位与不同手指无力相对应。手 knob 出血的原因是高血压，而手 knob 梗死的原因主要是小血管闭塞（SVO）（35.3%）和大动脉粥样硬化（LAA）（35.3%），罕见病因包括颈动脉夹层和颈动脉体瘤。中位随访 13.5 个月后，94.7%患者的预后良好，1 例（5.3%）患者复发卒中。
手 knob 卒中是一种罕见的预后良好、卒中复发率低的卒中。缺血性卒中占主导地位，主要临床表现为手部无力。手 knob 出血的原因是高血压，而 SVO 和 LAA 是手 knob 梗死的主要原因，但也存在一些罕见病因。
