Isolated Wrist Drop Presenting as Acute Stroke: Rare Case Report with Review of Literature.

Isolated wrist drop is very unusual clinical presentation due to cerebral stroke. It is highly confused with peripheral neuropathy. However, timely detection of acute stroke as one of the causes of wrist drop is necessary as it changes the line of treatment and prognosis significantly. Here we are presenting a 62 year-old diabetic and hypertensive male patient who came with acute onset weakness of right hand. Initial Magnetic resonance imaging (MRI) of the brain showed hyperacute infarct in the splenium of corpus callosum. Magnetic resonance angiography (MRA) was normal. Repeat brain MRI on next day showed acute infarct at hand area of motor strip in posterior frontal region. The patient underwent intravenous thrombolysis and thereafter improved significantly. Isolated hand palsy is a rare presentation of stroke, often mistaken for peripheral lesion.

Hyperkalemia: A rare cause of acute flaccid quadriparesis.

Acute flaccid quadriparesis secondary to hyperkalemia is a very rare and serious but reversible medical emergency. We present a case of a 73-year-old female who was admitted with rapidly progressive ascending paraparesis progressing to quadriparesis in about 10 h due to hyperkalemia. Patient was treated with antihyperkalemic measures. Her power improved dramatically as potassium levels normalized and she had an uneventful recovery.

Acute ischemic stroke in a child with cyanotic congenital heart disease due to non-compliance of anticoagulation.

BACKGROUND: Stroke is a common presentation in geriatric patients in emergency department but rarely seen in pediatric patients. In case of acute ischemic stroke in pediatric age group, management is different from that of adult ischemic stroke where thrombolysis is a good op. METHODS: We report a case of a 17-year-old male child presenting in emergency with an episode of acute ischemic stroke causing left hemiparesis with left facial weakness and asymmetry. The patient suffered from cyanotic congenital heart disease for which he had undergone Fontan operation previously. He had a history of missing his daily dose of warfarin for last 3 days prior to the stroke. RESULTS: The patient recovered from acute ischemic stroke without being thrombolyzed. CONCLUSION: In pediatric patients, acute ischemic stroke usually is evolving and may not require thrombolysis.