Diffusion‐Weighted MRI Diagnosis of Pure Motor Stroke Limited to Primarily Distal Leg Weakness

Abstract

Pure motor stroke (PMS) manifesting as distal weakness of a single extremity has rarely been described. The authors report a 59-year-old man with PMS who had primarily distal weakness of a single lower extremity, which to the authors' knowledge has not been previously described. Four days after onset, positive diffusion-weighted imaging confirmed that the small subcortical T2-weighted hyper-enhancing and nonenhancing T1-weighted hypo-intensity noted on magnetic resonance imaging (MRI) represented an acute PMS that was the cause of the patient's weakness. Increased awareness of this rare clinical presentation of PMS coupled with the promise of imaging the PMS with diffusion-weighted MRI should lead to earlier stroke intervention in these patients.

Pure monoparesis of the leg due to cerebral infarctions: A diffusion-weighted imaging study

“…Of the two patients who had corona radiata infarctions, Patient 4 had a lesion located posteriorly at the level of the ventricles, which supports reports of somatotopic organization of the motor fibres in the corona radiata, 14,15 and patient 3 had two lesions along the long axis of the corona radiata, but we think that the posterior lesion was the causative lesion, as previously suggested. 14,15 In ACA territory infarctions, lesions located in the paracentral gyrus, [16][17][18] or posterior infarcts involving the precentral gyrus 19,20 and subcortical lesions, 21 are responsible for causing pure leg monoparesis. The clinical presentations of patient 6, who had cortical lesions, and patient 5, who had lesions in the subcortical white matter of the posterior frontal lobe, are consistent with those in previous reports, indicating that leg motor fibres pass through subcortical locations, as shown by patient 5.…”

İsolated Wrıst Palsy Due To Cortıcal İnfarction: A Case Report

“…Duyu kusuru olmaksızın tek ekstremitede sınırlı izole motor defisit ile ortaya çıkan saf motor monoparezi (SMM) seyrek karşılaşılan bir durumdur (1). SMM kolaylıkla hatalı teşhis edilebilecek ve kuvvetsizliğin diğer nedenleri ile karışabilecek önemli bir sendromdur.…”