title: Acute tetraparesis secondary to bilateral precentral gyral cerebral ischemia: a case report.
abstract: BACKGROUND
  Sudden tetraparesis represents a neurological emergency and is most often caused by traumatic spinal cord injury, spinal epidural bleeding or brainstem ischemia and less frequently by medial disc herniation or spinal ischemia.
  
  
  METHODS
  Here we report the rare case of an 82-year-old Caucasian man who developed severe tetraparesis four days after radical cystoprostatectomy. An emergency diagnostic study for spinal cord affection was normal. Brain magnetic resonance imaging revealed acute bilateral ischemic strokes in the precentral gyri as the underlying cause.
  
  
  CONCLUSIONS
  This case report underlines the need to also consider unusual causes of tetraparesis in an emergency situation apart from spinal cord or brain stem injury in order not to leave severe symptomatology unclear and possibly miss therapeutic options.
authors.affiliation: Department of Neurology, University of Würzburg, Josef-Schneider-Str, 11, Wuerzburg 97080, Germany. Gunreben_I@klinik.uni-wuerzburg.de.
authors.forename: Christian
authors.initials: C
authors.lastname: Geis
authors.forename: Ignaz
authors.initials: I
authors.lastname: Gunreben
authors.forename: Christoph
authors.initials: C
authors.lastname: Kleinschnitz