Pseudomedian Claw Hand in Cortical Infarct: A Case Report.

Area of Science:

• Neuroscience
• Neurology
• Stroke Medicine

Background:

• Isolated hand weakness following a stroke is a rare clinical presentation.
• It is frequently misdiagnosed as a peripheral nerve lesion, leading to delayed or incorrect treatment.
• Central neurological deficits can manifest as apparent peripheral nerve palsies.

Purpose of the Study:

• To describe a unique case of isolated hand weakness resulting from a stroke.
• To illustrate how central lesions can mimic peripheral nerve damage, specifically pseudomedian, pseudoulnar, and pseudoradial nerve palsies.
• To emphasize the importance of considering central causes in cases of isolated hand weakness.

Main Methods:

• Case report detailing a patient with isolated hand weakness.
• Clinical examination findings focusing on hand and finger motor deficits.
• Neuroimaging results confirming a cortical infarct as the etiology.

Main Results:

• The patient presented with a median claw hand deformity.
• This presentation was attributed to a specific cortical infarct, not a peripheral nerve issue.
• The findings demonstrate a central cause for symptoms typically associated with peripheral nerve damage.

Conclusions:

• Cortical infarcts can cause isolated hand weakness mimicking peripheral nerve palsies.
• Recognition of central causes is crucial for accurate diagnosis and management of hand weakness after stroke.
• This case underscores the complexity of central nervous system control over fine motor hand movements.