“Cortical” Wrist Drop due to a Cerebral Peduncle Infarct
Wrist drops are usually due to a peripheral neuropathy affecting the radial nerve. Cortical wrist drops may occur, usually due to a lesion in the contralateral hand area of the motor cortex. We report a unique case of “cortical” wrist drop due to an acute infarction of the contralateral cerebral ped...
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| Format: | Article |
| Language: | English |
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Karger Publishers
2020-12-01
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| Series: | Case Reports in Neurology |
| Subjects: | |
| Online Access: | https://www.karger.com/Article/FullText/504128 |
| _version_ | 1818383252365246464 |
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| author | Narayanaswamy Venketasubramanian Amogh Narayan Hegde Yeow Wai Lim |
| author_facet | Narayanaswamy Venketasubramanian Amogh Narayan Hegde Yeow Wai Lim |
| author_sort | Narayanaswamy Venketasubramanian |
| collection | DOAJ |
| description | Wrist drops are usually due to a peripheral neuropathy affecting the radial nerve. Cortical wrist drops may occur, usually due to a lesion in the contralateral hand area of the motor cortex. We report a unique case of “cortical” wrist drop due to an acute infarction of the contralateral cerebral peduncle. The patient is a 70-year-old gentleman with the vascular factors of hypertension, hyperlipidaemia, and prior cerebellar strokes, who developed sudden onset of right wrist weakness without numbness. Neurological examination showed a right wrist and finger drop. Nerve conduction study of the radial nerve was normal. MRI brain revealed an acute infarct in the medial part of the left cerebral peduncle, extending slightly to the medial thalamus; there were also old medial posterior cerebellar infarcts. Time of flight MR angiography was normal, with hypoplastic right vertebral artery. Echocardiography was normal but for a dilated right atrium. Electrocardiogram was normal, and 24-hour Holter monitoring detected infrequent atrial and ventricular ectopics. X-ray wrist showed an old ulnar styloid fracture. Nerve conduction study of the radial nerve was normal. He was switched from aspirin to clopidogrel and underwent rehabilitation. The cerebral peduncle should not be forgotten when attempting to anatomically localise the site of the lesion when evaluating a patient with a wrist drop. |
| first_indexed | 2024-12-14T03:03:25Z |
| format | Article |
| id | doaj.art-1b6f63d31e2e4fe2a6b9c5c96c030c84 |
| institution | Directory Open Access Journal |
| issn | 1662-680X |
| language | English |
| last_indexed | 2024-12-14T03:03:25Z |
| publishDate | 2020-12-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Case Reports in Neurology |
| spelling | doaj.art-1b6f63d31e2e4fe2a6b9c5c96c030c842022-12-21T23:19:27ZengKarger PublishersCase Reports in Neurology1662-680X2020-12-0112120721110.1159/000504128504128“Cortical” Wrist Drop due to a Cerebral Peduncle InfarctNarayanaswamy VenketasubramanianAmogh Narayan HegdeYeow Wai LimWrist drops are usually due to a peripheral neuropathy affecting the radial nerve. Cortical wrist drops may occur, usually due to a lesion in the contralateral hand area of the motor cortex. We report a unique case of “cortical” wrist drop due to an acute infarction of the contralateral cerebral peduncle. The patient is a 70-year-old gentleman with the vascular factors of hypertension, hyperlipidaemia, and prior cerebellar strokes, who developed sudden onset of right wrist weakness without numbness. Neurological examination showed a right wrist and finger drop. Nerve conduction study of the radial nerve was normal. MRI brain revealed an acute infarct in the medial part of the left cerebral peduncle, extending slightly to the medial thalamus; there were also old medial posterior cerebellar infarcts. Time of flight MR angiography was normal, with hypoplastic right vertebral artery. Echocardiography was normal but for a dilated right atrium. Electrocardiogram was normal, and 24-hour Holter monitoring detected infrequent atrial and ventricular ectopics. X-ray wrist showed an old ulnar styloid fracture. Nerve conduction study of the radial nerve was normal. He was switched from aspirin to clopidogrel and underwent rehabilitation. The cerebral peduncle should not be forgotten when attempting to anatomically localise the site of the lesion when evaluating a patient with a wrist drop.https://www.karger.com/Article/FullText/504128strokeinfarctwrist dropcerebral peduncle |
| spellingShingle | Narayanaswamy Venketasubramanian Amogh Narayan Hegde Yeow Wai Lim “Cortical” Wrist Drop due to a Cerebral Peduncle Infarct Case Reports in Neurology stroke infarct wrist drop cerebral peduncle |
| title | “Cortical” Wrist Drop due to a Cerebral Peduncle Infarct |
| title_full | “Cortical” Wrist Drop due to a Cerebral Peduncle Infarct |
| title_fullStr | “Cortical” Wrist Drop due to a Cerebral Peduncle Infarct |
| title_full_unstemmed | “Cortical” Wrist Drop due to a Cerebral Peduncle Infarct |
| title_short | “Cortical” Wrist Drop due to a Cerebral Peduncle Infarct |
| title_sort | cortical wrist drop due to a cerebral peduncle infarct |
| topic | stroke infarct wrist drop cerebral peduncle |
| url | https://www.karger.com/Article/FullText/504128 |
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