A case of pure hand knob mild infarction diagnosed by MRI diffusion-weighted image

We report a case of acute cerebral infarction in which a patient had with a complaint of drooping hand and had a good outcome with thrombolytic therapy. A 75-year-old man suffered from sudden weakness of peripheral muscles from the right wrist. MRI scan of the brain showed acute cerebral infarction confined to the left motor cortex, and he was treated by intravenous thrombolytic therapy with rt-PA. The neurological symptoms had rapidly been improved. Thereafter, there was no recurrence of neurological deficit and the patient was discharged back to his home without any neurological deficits (m-RS: 0). Cerebral infarction with weakness of distal limbs is rare, and differentiating it from peripheral neuropathy is challenging. Since finger function greatly affects daily life, early intervention of appropriate treatment would extremely be important if the cause were cerebral ischemia. In this case, early diagnosis and therapeutic intervention resulted in a favorable outcome.