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Performing Permanent Distal Middle Cerebral with Common Carotid Artery Occlusion in Aged Rats to Study Cortical Ischemia with Sustained Disability

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"Cortical" Wrist Drop due to a Cerebral Peduncle Infarct.

Narayanaswamy Venketasubramanian¹, Amogh Narayan Hegde², Yeow Wai Lim³

¹Raffles Neuroscience Centre, Raffles Hospital, Singapore, Singapore.

Case Reports in Neurology

|January 28, 2021

Summary

A rare case of wrist drop was caused by a cerebral peduncle infarction, not typical radial nerve damage. This finding highlights the importance of considering the cerebral peduncle in diagnosing wrist drop.

Keywords:

Cerebral peduncle Infarct Stroke Wrist drop

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Area of Science:

Neurology
Neuroscience
Neuroimaging

Background:

Wrist drop typically results from radial nerve neuropathy.
Cortical wrist drop is usually associated with motor cortex lesions.
Accurate localization of neurological lesions is crucial for effective treatment.

Observation:

A 70-year-old male with hypertension and hyperlipidemia presented with sudden right wrist and finger drop.
Neurological examination revealed wrist drop, but nerve conduction studies of the radial nerve were normal.
Brain MRI identified an acute infarct in the medial left cerebral peduncle, extending to the medial thalamus.

Findings:

The patient's wrist drop was attributed to an acute infarct in the cerebral peduncle, a rare cause.
Standard tests for peripheral neuropathy (nerve conduction studies) were negative, ruling out radial nerve damage.
Cerebral peduncle lesions, though uncommon, can manifest as wrist drop, challenging typical diagnostic pathways.

Implications:

This case underscores the necessity of including the cerebral peduncle in the differential diagnosis of wrist drop.
Neuroimaging, particularly MRI, is vital for identifying non-peripheral causes of wrist drop.
Understanding rare etiological pathways for neurological deficits improves diagnostic accuracy and patient management.