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Spinal Cord Lateral Hemisection and Asymmetric Behavioral Assessments in Adult Rats
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Sacral pseudoradiculopathy due to centrum semiovale stroke.

L B Goldstein1

  • 1Department of Medicine, Duke University, Durham, NC, USA.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|September 1, 1996
PubMed
Summary

A rare case of stroke mimicking sacral radiculopathy highlights that subcortical brain lesions can cause pseudoperipheral deficits. This suggests thalamocortical pathways retain dermatomal organization in the centrum semiovale.

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Area of Science:

  • Neurology
  • Neuroscience
  • Stroke Research

Background:

  • Localized cerebral cortical lesions can cause pseudoperipheral neurologic deficits.
  • Subcortical lesions have not been previously associated with such deficits.
  • Sacral radiculopathy affects the S1-S2 dermatome, mimicking lower limb sensory and motor disturbances.

Purpose of the Study:

  • To report a unique case of stroke presenting as sacral pseudoradiculopathy.
  • To investigate the potential for subcortical lesions to cause peripheral nerve-like deficits.
  • To explore the organization of thalamocortical projections in the centrum semiovale.

Main Methods:

  • Case study of a 60-year-old male patient with hypertension.
  • Clinical examination revealing sacral pseudoradiculopathy and hyperreflexia.
  • Brain magnetic resonance imaging (MRI) to identify the intracranial lesion.

Main Results:

  • An isolated infarct in the centrum semiovale, deep to the motor and sensory cortices, was identified.
  • The patient's symptoms mimicked an S1-S2 sacral radiculopathy.
  • Hyperreflexia suggested an intracranial origin for the neurologic deficits.

Conclusions:

  • Stroke can present atypically, mimicking peripheral nerve conditions like sacral radiculopathy.
  • Subcortical lesions, specifically in the centrum semiovale, can lead to pseudoperipheral neurologic deficits.
  • Thalamocortical projections may maintain dermatomal organization within the centrum semiovale, explaining the observed sensory disturbance pattern.