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Journal of Korean Neurosurgical Society 2007;41(3): 182-185.
doi: https://doi.org/10.3340/jkns.2007.41.3.182
Isolated Distal Leg Weakness due to a Small Cerebral Infarction Masquerading as a Spinal Lesion.
In Bo Han, Jung Yong Ahn, Young Sun Chung, Sang Sup Chung
1Department of Neurosurgery, Bundang CHA Hospital, Pochon CHA University, Seongnam, Korea. cysns@yahoo.co.kr
2Department of Neurosurgery, Yonsei University, Severance Hospital, Seoul, Korea.
ABSTRACT
Acute stroke with isolated monoparesis manifesting as distal weakness of a single lower extremity has rarely been described. We report two patients with small cortical infarction who had distal weakness of a single lower extremity. In both cases, diffusion-weighted image (DWI) was used to detect small lesions in the contralateral cortex. These cases illustrate that small cortical infarction can cause isolated monoparesis limited to distal part of the leg and it may be misdiagnosed as spinal lesions, especially when lower back pain and transient sensory symptoms are accompanied. In case of the abrupt onset of weakness limited to one lower limb, the possibility of stroke should be considered and careful attention to identify cortical lesions using magnetic resonance imaging, especially DWI is required.
Key Words: Pure motor monoparesis; Cerebral infarction
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