Ipsilateral hemiparesis in ischemic stroke patients

Area of Science:

• Neuroscience
• Neurology
• Clinical Medicine

Background:

• Ipsilateral hemiparesis, weakness on the same side as a brain lesion, is uncommon in ischemic stroke.
• Understanding its underlying mechanisms is crucial for stroke rehabilitation and management.

Purpose of the Study:

• To investigate the clinical characteristics and neuroimaging findings of patients experiencing ipsilateral hemiparesis following an acute ischemic stroke.

Main Methods:

• Prospective examination of acute ischemic stroke patients.
• Definition of ipsilateral hemiparesis relative to recent stroke lesions.
• Utilized functional neuroimaging, including transcranial magnetic stimulation (TMS) and functional MRI.

Main Results:

• Identified 14 cases (0.17%) of ipsilateral hemiparesis among 8360 ischemic stroke patients.
• Lesions were primarily along the corticospinal tract; most patients had prior contralateral strokes with motor deficits.
• TMS and functional MRI showed evidence of both ipsilateral and contralateral corticospinal tract activation.

Conclusions:

• A history of contralateral stroke with motor deficits is common in patients with ipsilateral hemiparesis.
• Functional neuroimaging suggests the crossed corticospinal tract is active, and the uncrossed tract may compensate for motor deficits post-stroke.