Clinical features, etiology, and prognosis of hand knob stroke: a case series

Background Hand knob stroke is a rare clinical disorder frequently misdiagnosed as peripheral neuropathy. The purpose of this study is to recognize this particular type of stroke by analyzing clinical features, etiology, and prognosis. Methods We enrolled 19 patients with acute hand knob stroke in t...

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Bibliographic Details
Published in:BMC neurology 2022-09, Vol.22 (1), p.1-331, Article 331
Main Authors: Zhang, Zhiyong, Sun, Xiaoxin, Liu, Xinxiu, Wang, Lei, Zhu, Rui
Format: Article
Language:English
Subjects:
Alcoholism
Anticoagulants
Arteriosclerosis
Carotid arteries
Carotid artery
Carotid body
Causes of
Cerebral infarction
Diabetes
Diagnosis
Disease
Etiology
Geriatrics
Hand
Hand knob stroke
Hand motor cortex
Hand paralysis
Hemorrhage
Hypertension
Ischemia
Magnetic resonance imaging
Medical imaging
Paralysis
Paresis
Patients
Peripheral neuropathy
Prognosis
Risk factors
Statistical analysis
Stroke
Stroke (Disease)
Tumors
Veins & arteries
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Summary:Background Hand knob stroke is a rare clinical disorder frequently misdiagnosed as peripheral neuropathy. The purpose of this study is to recognize this particular type of stroke by analyzing clinical features, etiology, and prognosis. Methods We enrolled 19 patients with acute hand knob stroke in the Department of Neurology of the Beijing Geriatric Hospital from January 2018 to January 2022, and the clinical and imaging data of the patients during hospitalization and follow-up were collected and summarized. Results Acute hand knob stroke accounted for 0.9% of all acute stroke, and ischemic stroke (17 cases, 89.5%) was more than hemorrhagic stroke (2 cases, 10.5%). All patients presented sudden contralateral hand paresis, 12 (63.2%) of them had only isolated hand paralysis, and the location of the lesion corresponded to different finger weakness. The cause of hand knob hemorrhage was hypertension, while the causes of hand knob infarction were mainly small-vessel occlusion (SVO) (35.3%) and large-artery atherosclerosis (LAA) (35.3%), and the rare causes include carotid artery dissection and carotid body tumor. After a median follow-up 13.5 months, the prognosis of 94.7% patients was good, and one patient (5.3%) had recurrent stroke. Conclusions Hand knob stroke is a rare stroke with a good prognosis and a low stroke recurrence rate. Ischemic stroke is the predominant type and the main clinical manifestation is hand paresis. The cause of hand knob hemorrhage is hypertensive, while SVO and LAA are the main causes of hand knob infarction, but there are some rare etiologies. Keywords: Hand knob stroke, Hand motor cortex, Hand paralysis, Stroke, Etiology
ISSN:1471-2377
1471-2377
DOI:10.1186/s12883-022-02858-0