title: Isolated shoulder palsy due to cortical infarction: a case report and literature review of clinicoradiological correlations.
abstract: Clinicoradiological correlations observed in patients with small cortical infarctions have supported somatotopic representation of different parts of body areas in primary motor cortex. However, isolated shoulder weakness because of infarction in precentral gyrus has rarely been described. We report an 80-year-old woman with isolated shoulder palsy because of cortical ischemic infarction in the base of the left precentral gyrus as confirmed by brain magnetic resonance imaging. In our patient, cardiogenic embolism or Trousseau syndrome associated with lung cancer was considered the cause of ischemic infarction. Physicians should consider small cortical infarction, when a patient complains of sudden onset of shoulder weakness without pain. In line with the previous reports, a responsible cortical lesion in our patient corresponded to motor shoulder area in the motor homunculus reported to be located more medially to the hand area.
authors.affiliation: Department of Neurology, Dokkyo Medical University, Tochigi, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Kawasaki
authors.forename: Keisuke
authors.initials: K
authors.lastname: Suzuki
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Takekawa
authors.forename: Norito
authors.initials: N
authors.lastname: Kokubun
authors.forename: Masanari
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Yohei
authors.initials: Y
authors.lastname: Asakawa
authors.forename: Madoka
authors.initials: M
authors.lastname: Okamura
authors.forename: Koichi
authors.initials: K
authors.lastname: Hirata
mesh_terms: D000369:Aged, 80 and over; D020520:Brain Infarction / Q000175:diagnosis / Q000209:etiology*; D038524:Diffusion Magnetic Resonance Imaging; D017809:Fatal Outcome; D005260:Female; D006331:Heart Diseases / Q000209:etiology; D006801:Humans; D020766:Intracranial Embolism / Q000209:etiology; D008175:Lung Neoplasms / Q000150:complications; D018810:Magnetic Resonance Angiography; D009044:Motor Cortex / Q000098:blood supply*; D010243:Paralysis / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D012782:Shoulder / Q000294:innervation*
keywords: Brain magnetic resonance images; Trousseau syndrome; isolated shoulder palsy; precentral gyrus