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J Neurol Neurosurg Psychiatry 2005;76:805-807 doi:10.1136/jnnp.2004.047779
  • Paper

Isolated monoparesis following stroke

  1. M Paciaroni,
  2. V Caso,
  3. P Milia,
  4. M Venti,
  5. G Silvestrelli,
  6. F Palmerini,
  7. K Nardi,
  8. S Micheli,
  9. G Agnelli
  1. Stroke Unit, Department of Neuroscience, University of Perugia, Perugia, Italy
  1. Correspondence to:
 Dr Maurizio Paciaroni
 Department of Neuroscience, University of Perugia, Via Enrico dal Pozzo, 06126 Perugia, Italy; mpaciaronilibero.it
  • Received 16 June 2004
  • Accepted 28 September 2004
  • Revised 5 September 2004

Abstract

Background: Some investigators have stated that monoparesis is almost never the result of a lacunar infarct or cerebral haemorrhage.

Objective: To describe the topography and aetiology in a consecutive population where first ever stroke was manifested by isolated monoparesis.

Methods: Patients with motor paresis of only one limb were included consecutively in the study. A neuroradiologist determined stroke location, while a neurologist reviewed the clinical records to assign stroke subtype. Both physicians worked blind to each other’s findings.

Results: 51 of 2003 patients (2.5%) had isolated monoparesis, and of these 39 (76.5%) were ischaemic strokes and 12 (23.5%) were haemorrhagic. Cardioembolism was the cause of stroke in 15.7%, atherosclerosis in 9.8%, and small artery disease in 39.2%. Most of the haemorrhages were in the thalamic-capsular region (5/12). Most of the ischaemic lesions were in the deep territory of the middle cerebral artery, the corona radiate, or the centrum semiovale (20/39); 16 of 39 were in the cortical territories or the watershed region.

Conclusions: Isolated monoparesis is a rare symptom in stroke patients and is often caused by small artery disease or a small haemorrhage.

Footnotes

  • Competing interests: none declared

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