Stroke Chameleons Manifesting as Distinct Radial Neuropathies: Expertise Can Hasten the Diagnosis
Objective: Stroke chameleons encompass an atypical group of syndromes that do not initially appear to be cerebrovascular accidents. The objective of this study was to report patients with different lesions of central origin clinically presenting as wrist drop and with a semiology similar to that pro...
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doaj-88b3af0acd584de48f548a4c4a2df6d72020-11-24T22:25:58ZengKarger PublishersCase Reports in Neurology1662-680X2017-12-019327728310.1159/000480229480229Stroke Chameleons Manifesting as Distinct Radial Neuropathies: Expertise Can Hasten the DiagnosisFabrício Diniz de LimaGustavo José LuvizuttoArthur Oscar SchelpGabriel Pereira BragaRodrigo BazanObjective: Stroke chameleons encompass an atypical group of syndromes that do not initially appear to be cerebrovascular accidents. The objective of this study was to report patients with different lesions of central origin clinically presenting as wrist drop and with a semiology similar to that produced by peripheral lesions of the radial nerve at different topographical levels. Methods: This is a case series study of patients presenting with wrist drop during the acute phase of stroke who were assessed by clinical examination and CT and MRI brain scans. Results: Three cases presenting as monoparesis were evaluated. In all patients, the MRI revealed restricted diffusion in the pre- and post-central gyrus. Electromyography showed that the functionality of the radial, median, and ulnar nerves were intact in all three cases. The monoparesis resolved completely within 1 month of rehabilitation therapy, and no evidence of recurrent or new events was reported during the 6-month follow-up after stenting. Conclusion: The central message of this study is that when acute onset symptoms are present in a relatively old patient with vascular risk factors, stroke should be considered as the possible aetiology until proven otherwise, and the appropriate steps should be taken to avoid a delay in the treatment and to improve outcomes.https://www.karger.com/Article/FullText/480229Stroke chameleonsRadial neuropathiesCerebrovascular diseaseDiagnosisOutcomes |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Fabrício Diniz de Lima Gustavo José Luvizutto Arthur Oscar Schelp Gabriel Pereira Braga Rodrigo Bazan |
spellingShingle |
Fabrício Diniz de Lima Gustavo José Luvizutto Arthur Oscar Schelp Gabriel Pereira Braga Rodrigo Bazan Stroke Chameleons Manifesting as Distinct Radial Neuropathies: Expertise Can Hasten the Diagnosis Case Reports in Neurology Stroke chameleons Radial neuropathies Cerebrovascular disease Diagnosis Outcomes |
author_facet |
Fabrício Diniz de Lima Gustavo José Luvizutto Arthur Oscar Schelp Gabriel Pereira Braga Rodrigo Bazan |
author_sort |
Fabrício Diniz de Lima |
title |
Stroke Chameleons Manifesting as Distinct Radial Neuropathies: Expertise Can Hasten the Diagnosis |
title_short |
Stroke Chameleons Manifesting as Distinct Radial Neuropathies: Expertise Can Hasten the Diagnosis |
title_full |
Stroke Chameleons Manifesting as Distinct Radial Neuropathies: Expertise Can Hasten the Diagnosis |
title_fullStr |
Stroke Chameleons Manifesting as Distinct Radial Neuropathies: Expertise Can Hasten the Diagnosis |
title_full_unstemmed |
Stroke Chameleons Manifesting as Distinct Radial Neuropathies: Expertise Can Hasten the Diagnosis |
title_sort |
stroke chameleons manifesting as distinct radial neuropathies: expertise can hasten the diagnosis |
publisher |
Karger Publishers |
series |
Case Reports in Neurology |
issn |
1662-680X |
publishDate |
2017-12-01 |
description |
Objective: Stroke chameleons encompass an atypical group of syndromes that do not initially appear to be cerebrovascular accidents. The objective of this study was to report patients with different lesions of central origin clinically presenting as wrist drop and with a semiology similar to that produced by peripheral lesions of the radial nerve at different topographical levels. Methods: This is a case series study of patients presenting with wrist drop during the acute phase of stroke who were assessed by clinical examination and CT and MRI brain scans. Results: Three cases presenting as monoparesis were evaluated. In all patients, the MRI revealed restricted diffusion in the pre- and post-central gyrus. Electromyography showed that the functionality of the radial, median, and ulnar nerves were intact in all three cases. The monoparesis resolved completely within 1 month of rehabilitation therapy, and no evidence of recurrent or new events was reported during the 6-month follow-up after stenting. Conclusion: The central message of this study is that when acute onset symptoms are present in a relatively old patient with vascular risk factors, stroke should be considered as the possible aetiology until proven otherwise, and the appropriate steps should be taken to avoid a delay in the treatment and to improve outcomes. |
topic |
Stroke chameleons Radial neuropathies Cerebrovascular disease Diagnosis Outcomes |
url |
https://www.karger.com/Article/FullText/480229 |
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