Acute pure motor hemiparesis can occur due to a vascular insult along the cortico spinal pathway. Rarely such a stroke can occur as a result of involvement of the pyramids located on the ventral aspect of the medulla. Neurological localization can be difficult in such strokes and moreover they can also pose imaging challenges since they are missed on the CT scans. So far only 4 such cases have been reported in literature. Here we present two cases of pure motor strokes caused by infarction of the medullary pyramids. We have described the anatomical correlates of the symptoms and signs and also highlight the importance of MRI in picking up these rare strokes.

急性纯运动性偏瘫可能是由于沿皮质脊髓途径的血管损伤所致。很少有这样的中风是由于位于延髓腹侧面的金字塔的参与而发生的。在这样的中风中，神经系统定位可能很困难，此外，由于在CT扫描中被遗漏，因此它们也可能带来成像挑战。迄今为止，文献中仅报道了4起此类病例。在这里，我们介绍了由髓金字塔梗死引起的纯运动中风的两种情况。我们已经描述了症状和体征的解剖学相关性，还强调了MRI在拾取这些罕见中风中的重要性。