Document Type
Article
Publication Title
Cureus
Abstract
A 38-year-old male smoker with chronic hypertension, anxiety secondary to alcohol withdrawal, chronic alcohol use, and a history of noncompliance with prescribed medications presented with 2 weeks of progressive left-sided weakness, numbness, dizziness, and gait instability. He also reported a month-long history of facial drooping that had not been formally evaluated. Brain magnetic resonance imaging revealed a small acute/subacute infarct in the left posterolateral cervicomedullary junction, at the level of the pyramidal decussation, which produced ipsilateral motor and sensory symptoms. This is a rare presentation of a stroke causing purely ipsilateral neurologic deficits and served as an important reminder of neurologic anatomy caudal to the pyramidal decussation.
DOI
10.7759/cureus.97461
Publication Date
11-21-2025
Keywords
brainstem infarction, cervicomedullary junction, corticospinal tract, ipsilateral hemiparesis, medulla oblongata, medullary infarction, pyramidal decussation, small vessel ischemic disease
ISSN
2168-8184
Recommended Citation
Thahab A, Bhardwaj S, Asfour M, Asfour B. Isolated Ipsilateral Hemiparesis From a Pyramidal Decussation Infarct: A Rare Case Confirmed by Magnetic Resonance Imaging. Cureus. 2025; 17(11). doi: 10.7759/cureus.97461.
