Isolated Index Finger Palsy Due to Cortical Infarction

• Published in: Journal of stroke and cerebrovascular diseases Vol. 23; no. 10; pp. e475 - e476
• Main Authors: Kawabata, Yuichi, MD, Miyaji, Yosuke, MD, Joki, Hideto, MD, Seki, Syunsuke, MD, Mori, Kentaro, MD, Kamide, Tomoya, MD, PhD, Tamase, Akira, MD, PhD, Nomura, Motohiro, MD, PhD, Kitamura, Yoshihisa, MD, PhD, Tanaka, Fumiaki, MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-11-2014
• Subjects: Aged, 80 and over; Aortic Diseases - complications; Aortic Diseases - diagnosis; aortogenic stroke; Brain Infarction - diagnosis; Brain Infarction - etiology; Cardiovascular; Cerebral Cortex - blood supply; Diffusion Magnetic Resonance Imaging; Echocardiography, Transesophageal; Fingers - innervation; Humans; Intracranial Embolism - diagnosis; Intracranial Embolism - etiology; Isolated index finger palsy; Male; Neurology; Paralysis - diagnosis; Paralysis - etiology; Paralysis - physiopathology; precentral gyrus; precentral knob; somatotopy; precentral gyrus; precentral knob; aortogenic stroke; somatotopy; Isolated index finger palsy
• ISSN: 1052-3057; 1532-8511
• DOI: 10.1016/j.jstrokecerebrovasdis.2014.07.042

The case of an 86-year-old man presenting with isolated left index finger palsy caused by infarction on the lateral side of the right precentral knob is presented. Embolization from aortic atheroma was considered the cause of infarction. Cases with selective palsy of a particular group of fingers without sensory deficits due to cortical infarction of the precentral knob have been reported by several authors, and predominant weakness of radial-side fingers is known to be usually caused by laterally located infarction of the precentral knob. Among the previous reports, only 1 case involved isolated index finger palsy by an atypical, medially located infarction of the precentral knob in association with a concurrent nonrelated lesion. This is the first reported isolated index finger palsy caused by a single lateral precentral knob infarction.