Introduction

There are few reported cases of ipsilateral weakness following ischemic or hemorrhagic stroke. In these rare cases, ipsilateral weakness is typically the result of damage to uncrossed components of the corticospinal tract (CST) which were recruited in response to previous CST injury.

Patients and methods

We report a series of six cases of acute ipsilateral weakness or numbness following a hemorrhagic or ischemic stroke from three medical institutions in Saudi Arabia.

Results

Three of these patients presented with right-sided weakness caused by an ipsilateral right hemispheric stroke, while two exhibited left-sided symptoms and one had only left-sided numbness. In all six cases, the ipsilateral corona radiata, internal capsule, basal ganglia, insula, and thalamus were involved. No concomitant opposite hemisphere or brainstem lesion in none of the patients was evident. Two patients had previous strokes affecting the brainstem and left corona radiata, respectively. Complete stroke workup to reveal the cause of stroke was carried out, however no functional MRI was performed.

Conclusion

Ischemic or hemorrhagic stroke may indeed result in ipsilateral weakness or numbness, though in very rare cases. We assume that the most likely mechanism of their ipsilateral weakness subsequent to the ipsilateral stroke was a functional reorganization favoring CST pathways within the ipsilateral hemisphere.

中文翻译：

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同侧中风引起的同侧无力：病例系列

介绍

很少有缺血性或出血性中风后出现同侧无力的报道。在这些罕见的情况下，同侧无力通常是皮质脊髓束 (CST) 未交叉成分受损的结果，这些成分是为响应先前的 CST 损伤而募集的。

患者和方法

我们报告了来自沙特阿拉伯三个医疗机构的一系列 6 例出血性或缺血性中风后急性同侧无力或麻木的病例。

结果

其中 3 名患者因同侧右半球中风导致右侧无力，2 名患者出现左侧症状，1 名患者仅有左侧麻木。在所有 6 个病例中，同侧放射冠、内囊、基底神经节、脑岛和丘脑均受累。没有患者明显伴有对侧半球或脑干损伤。两名患者既往有中风，分别影响脑干和左侧放射冠。进行了完整的中风检查以揭示中风的原因，但是没有进行功能性 MRI。

结论

缺血性或出血性中风确实可能导致同侧无力或麻木，但在极少数情况下。我们假设同侧中风后其同侧无力的最可能机制是同侧半球内有利于 CST 通路的功能重组。