Ipsilateral hemiparesis caused by subarachnoid hemorrhage in a patient with a ruptured middle cerebral artery aneurysm: a case report

Abstract

The authors report a patient with a ruptured middle cerebral artery (MCA) aneurysm who presented with ipsilateral hemiparesis. A computed tomographic (CT) scan and cerebral angiograms suggested that the ipsilateral hemiparesis was most likely due to compression by hematoma of the secondary motor area in the island of Reil. Two other cases that demonstrated ipsilateral motor weakness after rupture of MCA aneurysms have been reported. We emphasize not only the importance of considering dysfunction of the secondary motor area in patients with hemiparesis, but also the difficulty in differentiating ipsilateral secondary motor area dysfunction from contralateral primary motor area dysfunction in certain cases without CT scanning and angiography.