Isolated hemicape‐like sensory disturbance caused by a cortical infarction

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. © 2017 The Authors. Journal of General and Family Medicine published by John Wiley & Sons Australia, Ltd on behalf of Japan Primary Care Association. An 80yearold man with essential hypertension abruptly developed sensory disturbance in the region of the neck, shoulder, upper trunk, and brachium on the left side. Regarding subjective sensory disturbance of the hemicapelike distribution, combined sensation (topognosis, twopoint discrimination, graphesthesia, stereognosis, and quality extinction test) was impaired, despite spared superficial sensation (touch sensation, pain sensation, and temperature sensation) as well as deep sensation (joint sensation and vibratory sense). There were no other neurologic abnormalities. Consequently, the patient was diagnosed as having isolated hemicapelike sensory disturbance on the left side. Complete blood cell count, blood chemistry, and blood coagulation test were within normal ranges. Chest roentgenogram, electrocardiogram, transthoracic echocardiography, carotid ultrasonography and cranial magnetic resonance angiography findings were all normal. Diffusionweighted magnetic resonance imaging of the brain demonstrated a localized infarction in the postcentral gyrus on the right side which was superior medial to the precentral knob and other cortical area (Figure 1). Because embolic stroke of undetermined source1 or arterytoartery embolism was the most possible diagnoses, antiplatelet agent was initiated. Thereafter, the patient became asymptomatic within 14 days.