Pure sensory stroke due to brainstem lesion.

Area of Science:

• Neurology
• Neuroscience
• Stroke Medicine

Background:

• Brainstem strokes can present with diverse and sometimes subtle neurological deficits.
• Prompt diagnosis and management are critical for improving patient outcomes in stroke cases.

Observation:

• A 40-year-old male presented with acute right-sided hemisensory disturbances (numbness, tingling) affecting upper and lower extremities.
• Preceding symptoms included transient ataxia and left ocular pain, which resolved before presentation.
• Neurological examination confirmed isolated sensory deficits on the right side, with no other focal neurological abnormalities.

Findings:

• MRI revealed a small infarct in the left posterior brainstem, specifically at the pontomesencephalic junction.
• The patient received dual-antiplatelet therapy, with only minimal improvement in sensory symptoms during hospitalization.

Implications:

• This case underscores that brainstem strokes may manifest primarily as hemisensory symptoms, challenging initial diagnosis.
• It highlights the importance of a comprehensive neurological examination and maintaining a high index of suspicion for brainstem lesions, even with seemingly non-specific symptoms.
• Early identification of brainstem infarcts is vital for timely intervention and potentially mitigating long-term disability.