Ataxia-hemiparesis and cardiac embolic disease

Area of Science:

• Neurology
• Cardiology
• Radiology

Background:

• Ataxia-hemiparesis is a clinical syndrome characterized by disproportionately severe ataxia compared to mild weakness.
• Commonly associated with small lacunar infarcts in the brainstem or internal capsule, it can also stem from other pathologies like infection or neoplasm.
• This case highlights a less common etiology involving multiple infarcts secondary to cardiac sources.

Purpose of the Study:

• To present a case of ataxia-hemiparesis secondary to multiple infarcts from cardiac emboli.
• To emphasize the importance of comprehensive diagnostic workup in atypical stroke presentations.
• To underscore the potential role of anticoagulation in preventing recurrence.

Main Methods:

• A patient presented with right ataxia-hemiparesis.
• Initial cranial computed tomography (CT) was normal; a subsequent CT revealed infarcts in the cerebellum, thalamus, and frontal cortex.
• Echocardiography identified a left ventricular thrombus, indicative of a cardiac source for emboli.

Main Results:

• The patient's ataxia-hemiparesis was attributed to multiple infarcts in distinct brain regions.
• The identified left ventricular thrombus confirmed cardiac embolism as the cause.
• This case illustrates that ataxia-hemiparesis can be a manifestation of systemic embolic events.

Conclusions:

• Ataxia-hemiparesis can arise from multiple infarcts due to cardiac emboli.
• Prompt diagnosis of cardiac source and initiation of anticoagulation are vital for stroke prevention in such cases.
• This emphasizes the need for considering cardiac etiologies in patients presenting with stroke syndromes like ataxia-hemiparesis.