Capsular ataxic hemiparesis. Early diagnosis with MRI
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Abstract:
The Authors report a case of ataxic hemiparesis caused by a lacunar infarct involving the posterior limb of the right internal capsule, in a 64-year-old hypertensive man who completely recovered in about two weeks. The lesion was detected by MRI four days after the onset of illness, when the CT scan was normal. In patients presenting with ataxic hemiparesis, MRI is the most accurate tool in locating very small causative infarcts of the brainstem or the subcortical white matter.
Insights
A lacunar infarct in the internal capsule caused ataxic hemiparesis in a hypertensive man. Magnetic resonance imaging (MRI) detected the small lesion when computed tomography (CT) scans were normal, highlighting MRI
Area of Science:
- Neurology
- Radiology
- Neuroimaging
Background:
- Ataxic hemiparesis is a clinical syndrome characterized by ipsilateral ataxia and hemiparesis.
- Lacunar infarcts are small ischemic strokes typically affecting deep brain structures.
- Hypertension is a major risk factor for cerebrovascular diseases, including lacunar infarcts.
Observation:
- A 64-year-old hypertensive male presented with symptoms of ataxic hemiparesis.
- The causative lesion was identified as a lacunar infarct in the posterior limb of the right internal capsule.
- Clinical recovery was complete within approximately two weeks.
Findings:
- Computed tomography (CT) scans performed four days after symptom onset were normal.
- Magnetic resonance imaging (MRI) performed concurrently detected the small lacunar infarct.
- MRI demonstrated superior sensitivity in identifying the causative lesion compared to CT.
Implications:
- MRI is the most accurate neuroimaging modality for detecting small infarcts in cases of ataxic hemiparesis.
- Early and accurate diagnosis of lacunar infarcts is crucial for appropriate patient management.
- This case underscores the utility of MRI in diagnosing subtle ischemic lesions.