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Journal of Neurology Neurosurgery and Psychiatry 2003;74:1152-1153
© 2003 BMJ Publishing Group

SHORT REPORT

Deterioration of pre-existing hemiparesis brought about by subsequent ipsilateral lacunar infarction

T Ago1, T Kitazono1, H Ooboshi1, J Takada1, T Yoshiura2, F Mihara2, S Ibayashi1, M Iida1

1 Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
2 Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University,

Correspondence to:
Correspondence to:
Dr Tetsuro Ago, Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan;
agou{at}intmed2.med.kyushu-u.ac.jp


ABSTRACT
Mechanisms of post-stroke recovery are still poorly understood. Recent evidence suggests that cortical reorganisation in the unaffected hemisphere plays an important role. A 59 year old man developed a small lacunar infarct in the left corona radiata, which then caused marked deterioration in a pre-existing left hemiparesis that had resulted from an earlier right putaminal haemorrhage. Functional magnetic resonance imaging showed that the paretic left hand grip activated the ipsilateral left motor areas, but not the right hemispheric motor areas. This suggests that partial recovery of the left hemiparesis had been brought about by cortical reorganisation of the left hemisphere and intensification of the uncrossed corticospinal tract. The subsequent small infarct may have damaged the uncrossed tract, thereby causing the pre-existing hemiparesis to deteriorate even further.

Keywords: post-stroke recovery; cortical reorganisation; functional magnetic resonance imaging; ipsilateral hemiparesis




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eLetters:

Read all eLetters

Making matters worse, ipsilaterally: A new explanation
Iraj Derakhshan
JNNP Online, 21 Apr 2004 [Full text]
Authors' reply
Tetsuro Ago, et al.
JNNP Online, 17 Jun 2004 [Full text]

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