Isolated Shoulder Palsy due to Intracerebral Hemorrhage

A small cortical infarction confined to the medial location of the precentral knob on the precentral gyrus may cause isolated shoulder palsy. However, there are no reports indicating intracerebral hemorrhage as a cause of isolated shoulder palsy. We herein report the case of a 48-year-old man who pr...

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Published inInternal Medicine Vol. 57; no. 8; pp. 1159 - 1161
Main Authors Oyama, Yuta, Watanabe, Takehiro, Matsuno, Akira, Kanbayashi, Takamichi, Sonoo, Masahiro
Format Journal Article
LanguageEnglish
Published Japan The Japanese Society of Internal Medicine 01.01.2018
Japan Science and Technology Agency
Subjects
Case Report
Cerebral Hemorrhage - complications
cervical spondylotic amyotrophy
Cortex
Hemorrhage
Humans
idiopathic thrombocytopenic purpura
Infarction
Internal medicine
intracerebral hemorrhage
isolated shoulder palsy
Male
Middle Aged
Muscle Weakness - etiology
Paralysis
Paralysis - etiology
Precentral gyrus
Shoulder
Shoulder - pathology
Spine (cervical)
intracerebral hemorrhage
cervical spondylotic amyotrophy
idiopathic thrombocytopenic purpura
isolated shoulder palsy
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ISSN0918-2918
1349-7235
1349-7235
DOI10.2169/internalmedicine.9356-17

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Abstract A small cortical infarction confined to the medial location of the precentral knob on the precentral gyrus may cause isolated shoulder palsy. However, there are no reports indicating intracerebral hemorrhage as a cause of isolated shoulder palsy. We herein report the case of a 48-year-old man who presented with isolated shoulder palsy as an initial symptom of subcortical hemorrhage at the precentral gyrus. Such cases may be easily misdiagnosed as shoulder or cervical spine problems. The distribution of muscle weakness is the key to an accurate diagnosis.
AbstractList A small cortical infarction confined to the medial location of the precentral knob on the precentral gyrus may cause isolated shoulder palsy. However, there are no reports indicating intracerebral hemorrhage as a cause of isolated shoulder palsy. We herein report the case of a 48-year-old man who presented with isolated shoulder palsy as an initial symptom of subcortical hemorrhage at the precentral gyrus. Such cases may be easily misdiagnosed as shoulder or cervical spine problems. The distribution of muscle weakness is the key to an accurate diagnosis.A small cortical infarction confined to the medial location of the precentral knob on the precentral gyrus may cause isolated shoulder palsy. However, there are no reports indicating intracerebral hemorrhage as a cause of isolated shoulder palsy. We herein report the case of a 48-year-old man who presented with isolated shoulder palsy as an initial symptom of subcortical hemorrhage at the precentral gyrus. Such cases may be easily misdiagnosed as shoulder or cervical spine problems. The distribution of muscle weakness is the key to an accurate diagnosis.
A small cortical infarction confined to the medial location of the precentral knob on the precentral gyrus may cause isolated shoulder palsy. However, there are no reports indicating intracerebral hemorrhage as a cause of isolated shoulder palsy. We herein report the case of a 48-year-old man who presented with isolated shoulder palsy as an initial symptom of subcortical hemorrhage at the precentral gyrus. Such cases may be easily misdiagnosed as shoulder or cervical spine problems. The distribution of muscle weakness is the key to an accurate diagnosis.
Author Sonoo, Masahiro
Matsuno, Akira
Watanabe, Takehiro
Kanbayashi, Takamichi
Oyama, Yuta
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Cites_doi 10.1007/s10072-015-2213-2
10.1016/j.jns.2014.06.057
10.1212/01.WNL.0000094206.07513.12
10.3988/jcn.2006.2.3.209
10.3171/jns.1965.23.5.0528
10.1093/brain/60.4.389
10.2169/internalmedicine.50.4928
10.2169/internalmedicine.51.7806
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Issue 8
Keywords intracerebral hemorrhage
cervical spondylotic amyotrophy
idiopathic thrombocytopenic purpura
isolated shoulder palsy
Language English
License The Internal Medicine is an Open Access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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Correspondence to Dr.　Takamichi Kanbayashi, ta_kanba@yahoo.co.jp
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References_xml – reference: 8. Penfield W, Boldrey E. Somatic motor and sensory representation in the cerebral cortex of man as studied by electrical stimulation. Brain 69: 389-443, 1937.
– reference: 7. Sonoo M. Cervical spondylotic amyotrophy. Brain Nerve 68: 509-519, 2016 (in Japanese, Abstract in English).
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– reference: 1. Komatsu K, Fukutake T, Hattori T. Isolated shoulder paresis caused by a small cortical infarction. Neurology 61: 1457, 2003.
– reference: 5. Kanbayashi T, Hokkoku K, Hatanaka Y, Nishiyama K, Sonoo M. Isolated shoulder palsy diagnosed from needle EMG and an associated movement. Neurol Sci 36: 1527-1529, 2015.
– reference: 6. Keegan JJ. The cause of dissociated motor loss in the upper extremity with cervical spondylosis. J Neurosurg 23: 528-536, 1965.
– reference: 2. Nah HU, Park HK, Kang DW. Isolated shoulder weakness due to a small cortical infarction. J Clin Neurol 2: 209-211, 2006.
– reference: 10. Kawasaki A, Suzuki K, Takekawa H, et al. Isolated shoulder palsy due to cortical infarction: a case report and literature review of clinicoradiological correlations. J Stroke Cerebrovasc Dis 22: e687-e690, 2013.
– reference: 11. LoPresti MA, Bruce SS, Camacho E, et al. Hematoma volume as the major determinant of outcomes after intracerebral hemorrhage. J Neurol Sci 345: 3-7, 2014.
– reference: 3. Tsuda H, Kubota Y, Tanaka K, Kishida S. Isolated shoulder palsy due to a cortical infarction. Intern Med 50: 947, 2011.
– reference: 4. Tsuda H, Shinozaki Y, Tanaka K, Miura Y, Kishida S, Karasawa K. Isolated shoulder palsy due to infarction of the cortical branch of the middle cerebral artery. Intern Med 51: 2217-2219, 2012.
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  doi: 10.3171/jns.1965.23.5.0528
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  doi: 10.1093/brain/60.4.389
– ident: 3
  doi: 10.2169/internalmedicine.50.4928
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  doi: 10.2169/internalmedicine.51.7806
– ident: 10
– reference: 14638987 - Neurology. 2003 Nov 25;61(10):1457
– reference: 27156504 - Brain Nerve. 2016 May;68(5):509-19
– reference: 25894845 - Neurol Sci. 2015 Aug;36(8):1527-9
– reference: 22892507 - Intern Med. 2012;51(16):2217-9
– reference: 20396510 - J Clin Neurol. 2006 Sep;2(3):209-11
– reference: 25034055 - J Neurol Sci. 2014 Oct 15;345(1-2):3-7
– reference: 24008130 - J Stroke Cerebrovasc Dis. 2013 Nov;22(8):e687-90
– reference: 17874448 - Am J Hematol. 2008 Feb;83(2):122-5
– reference: 5858444 - J Neurosurg. 1965 Nov;23(5):528-36
– reference: 21498952 - Intern Med. 2011;50(8):947
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SubjectTerms Case Report
Cerebral Hemorrhage - complications
cervical spondylotic amyotrophy
Cortex
Hemorrhage
Humans
idiopathic thrombocytopenic purpura
Infarction
Internal medicine
intracerebral hemorrhage
isolated shoulder palsy
Male
Middle Aged
Muscle Weakness - etiology
Paralysis
Paralysis - etiology
Precentral gyrus
Shoulder
Shoulder - pathology
Spine (cervical)
Title Isolated Shoulder Palsy due to Intracerebral Hemorrhage
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