Cortical Infarction with Weakness of Individual Intrinsic Hand Muscles

J Korean Neurol Assoc > Volume 16(5); 1998 > Article

Journal of the Korean Neurological Association 1998;16(5): 697-700.

개별적 수부 내재근의 근력 저하를 동반한 대뇌 피질 경색

이필휴, 한상원 ? 허지회

연세대학교 의과대학 신경과학 교실

Cortical Infarction with Weakness of Individual Intrinsic Hand Muscles

Phil-Hyu Lee, M.D., Sang-Won Han, M.D., Ji-Hoe Heo, M.D.

Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.

Abstract

With the development of electrophysiologic technique, a more detailed topographical organizations of motor cortex, especially hand area have been introduced in animal experiment. To the best our knowledge, in cerebral infarction, only one patient with isolated weakness of intrinsic hand muscles has been reported. We present two patients with cerebral infarction who showed isolated weakness in their intrinsic hand. Patient 1; A 76-year-old woman with coronary artery obstructive disease developed abrupt weakness in flexion of right thumb, index, middle finger and in adduction of thumb. Brain MRI showed a small discrete lesion in the posterior bank of left precentral gyrus. An angiography revealed an occlusion of left central sulcus artery. Prominent thumb adduction weakness was remained 11 days later. Patient 2; A 57-year-old hypertensive man was admitted because of recurrent TIA and decreased grasp power of right hand, especially flexion and adduction of thumb, index finger and middle finger. Brain MRI showed focal lamina necrosis in left precentral gyrus. An angiography revealed an occlusion of left internal carotid artery. Findings in our patients suggest that the similar arrangement of efferent zone for cortical hand area found in monkeys also may exist in human beings. KEY WORDS; cortical infarction ? Intrinsic hand muscle weakness ? Cortical efferent zone