A Case of Ipsilateral Monoparesis by Lacunar Infarction: A Consideration on the Pathological Mechanism Akira Taniguchi 1 , Yuichiro Ii 1 , Yosuke Kawana 2 , Masaru Asahi 1 , Yutaka Naito 1 , Masunari Shibata 3,4 , Masayuki Maeda 5 , Hidekazu Tomimoto 1,3 1Department of Neurology,Mie University Graduate School of Medicine 2Department of Neurology,Mie Chuo Medical Center 3Department of Dementia Prevention and Therapeutics 4Department of Neurology,Yamada Red Cross Hospital 5Department of Radiology,Mie University School of Medicine Keyword: ipsilateral monoparesis , transcranial magnetic stimulation , MR tractography , pyramidal tract , lacunar infarction pp.177-180
Published Date 2011/2/1
DOI https://doi.org/10.11477/mf.1416100843
  • Abstract
  • Look Inside
  • Reference


 An 81-year-old man had sudden-onset dysarthria and weakness in the right leg, and was admitted to our hospital in July 2009. Neurological examination showed right leg monoparesis, sensory disturbance on the right limbs, dysarthria, and decreased deep tendon reflexes. Brain MRI revealed an acute lacunar infarction in the right corona radiata and an old lacunar infarction in the left centrum semiovale, which occurred 4 years before. MR tractography disclosed impaired motor fibers in the right corona radiata, and transcranial magnetic stimulation (TMS) suggested diminished innervation from the bilateral cerebral cortices to the right leg. These results collectively indicated that reorganization of the pyramidal fibers were responsible for the monoparesis ipsilateral to the lacunar infarction, although anomalous pyramidal fibers with ipsilateral innervation were responsible for ipsilateral hemiplegia a previous study.

(Received: March 15,2010,Accepted: October 24,2010)

Copyright © 2011, Igaku-Shoin Ltd. All rights reserved.


電子版ISSN 1344-8129 印刷版ISSN 1881-6096 医学書院