{"title":"Acute spasticity in malignant MCA stroke: a case report and review of literature.","authors":"Muhammad Faizan, Azza Halfawi, Alreem Alkuwari, Mohamad Ali, Mohamed Elgassim, Shahzad Anjum","doi":"10.1093/omcr/omaf114","DOIUrl":null,"url":null,"abstract":"<p><p>Malignant Middle cerebral artery (MCA) infarction is characterized by rapid neurological deterioration due to cerebral edema. Spasticity, a common sequela of stroke, typically occurs days to weeks after the initial event. However, an acute onset of spasticity at presentation is extremely rare. We report a case of a 40-year-old male patient who presented with spasticity accompanied by aphasia and decreased consciousness. Left MCA occlusion was demonstrated on Computed tomography (CT) angiography. Cerebral edema developed rapidly, requiring decompressive hemicraniectomy (DH). The patient was a known smoker with androgenic anabolic steroid use. This case represents a rare presentation of malignant MCA infarction with acute spasticity and adds a unique aspect to the clinical spectrum of stroke presentation. This case emphasizes the need for awareness of atypical stroke presentation and the potential role of anabolic steroids in stroke risk.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2025 7","pages":"omaf114"},"PeriodicalIF":0.4000,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296337/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Oxford Medical Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/omcr/omaf114","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/7/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
Malignant Middle cerebral artery (MCA) infarction is characterized by rapid neurological deterioration due to cerebral edema. Spasticity, a common sequela of stroke, typically occurs days to weeks after the initial event. However, an acute onset of spasticity at presentation is extremely rare. We report a case of a 40-year-old male patient who presented with spasticity accompanied by aphasia and decreased consciousness. Left MCA occlusion was demonstrated on Computed tomography (CT) angiography. Cerebral edema developed rapidly, requiring decompressive hemicraniectomy (DH). The patient was a known smoker with androgenic anabolic steroid use. This case represents a rare presentation of malignant MCA infarction with acute spasticity and adds a unique aspect to the clinical spectrum of stroke presentation. This case emphasizes the need for awareness of atypical stroke presentation and the potential role of anabolic steroids in stroke risk.
期刊介绍：
Oxford Medical Case Reports (OMCR) is an open access, peer-reviewed online journal publishing original and educationally valuable case reports that expand the field of medicine. The journal covers all medical specialities including cardiology, rheumatology, nephrology, oncology, neurology, and reproduction, comprising a comprehensive resource for physicians in all fields and at all stages of training. Oxford Medical Case Reports deposits all articles in PubMed Central (PMC). Physicians and researchers can find your work through PubMed , helping you reach the widest possible audience. The journal is also indexed in the Web of Science Core Collection . Oxford Medical Case Reports publishes case reports under the following categories: Allergy Audiovestibular medicine Cardiology and cardiovascular systems Critical care medicine Dermatology Emergency medicine Endocrinology and metabolism Gastroenterology and hepatology Geriatrics and gerontology Haematology Immunology Infectious diseases and tropical medicine Medical disorders in pregnancy Medical ophthalmology Nephrology Neurology Oncology Paediatrics Pain Palliative medicine Pharmacology and pharmacy Psychiatry Radiology, nuclear medicine, and medical imaging Respiratory disorders Rheumatology Sexual and reproductive health Sports Medicine Substance abuse.
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