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Pure dysarthria due to small cortical stroke
Jong S Kim1, Sun U Kwon, Te G Lee
1Department of Neurology, University of Ulsan, Asan Medical Center, Seoul, South Korea. jongskim@amc.seoul.kr
Neurology
|April 12, 2003
Summary
Small strokes affecting the brain cortex can cause isolated dysarthria, or speech difficulty. Diffusion-weighted MRI is crucial for detecting these subtle ischemic lesions, often missed by T2-weighted imaging.
Area of Science:
- Neurology
- Neuroradiology
- Neuroscience
Background:
- Dysarthria can be a presenting symptom of cerebrovascular events.
- Small cortical strokes may lead to focal neurological deficits.
- The diagnostic utility of different MRI sequences for subtle lesions requires elucidation.
Observation:
- Six patients presented with dysarthria as their primary or sole symptom.
- The underlying cause was a small cortical stroke in all cases.
- Five patients experienced ischemic stroke (infarction), and one had a hemorrhagic stroke.
Findings:
- Diffusion-weighted MRI (DW-MRI) successfully identified ischemic lesions.
- Standard T2-weighted MRI failed to detect these specific ischemic lesions.
- Lesions were consistently located laterally to the precentral knob, in the extreme lateral aspect of the imaging.
- Embolism was the presumed cause in five ischemic stroke cases.
- Hypertensive hemorrhage was the cause in the single hemorrhagic stroke case.
Implications:
- DW-MRI is essential for diagnosing small cortical strokes presenting with dysarthria.
- These findings refine the understanding of lesion localization for specific stroke types.
- Early and accurate diagnosis of small strokes is critical for timely intervention and management.