Focal finger palsy and wrist pain due to cortical infarction: a case report

Shiyu Hu, Yang Wang, Lijie Ren
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引用次数: 0

Abstract

Hand knob infarction induced focal weakness of contralateral hand or distal arm, only accounts for less than 1% of all ischemic strokes. To date, there is no case with pain during sleep as the onset symptoms being reported. The atypical symptoms of hand knob infarction might increase the risk of delaying treatment especially in the hyperacute phase of stroke. A 70-year-old man awoke from sleep due to sudden pain of his right medial wrist and presented to the emergency department with difficulty extending his right index and middle fingers within the time window of intravenous thrombolysis. But the intravenous thrombolysis was not given based on the NIHSS score (0) and atypical symptoms. MRI showed multiple DWI hyperintense lesions, including partial left hand knob area and left posterior central gyrus. CTA showed a severe focal stenosis of proximal left internal carotid artery. The hand knob infarction might onset with unusual pain and should be carefully inspected in patients combined with acute onset of focal hand paresis.
皮质梗死导致的局灶性手指麻痹和腕痛:病例报告
手部旋钮梗死导致的对侧手部或手臂远端局灶性无力,只占所有缺血性中风的不到 1%。迄今为止,还没有以睡眠时疼痛为首发症状的病例报道。手结梗死的非典型症状可能会增加延误治疗的风险,尤其是在中风的超急性期。一名 70 岁的男性因右腕内侧突然疼痛而从睡梦中醒来,在静脉溶栓时间窗内因右手食指和中指伸展困难而到急诊科就诊。但根据 NIHSS 评分(0 分)和非典型症状,没有给予静脉溶栓治疗。MRI 显示多个 DWI 高强度病变,包括部分左手钮区和左侧中央后回。CTA显示左侧颈内动脉近端有严重的局灶性狭窄。手部旋钮梗死发病时可能伴有异常疼痛,对于合并急性局灶性手部瘫痪的患者应仔细检查。
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CiteScore
1.90
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