# When Stroke Mimics Peripheral Nerve Injury: A Case Report of Isolated Wrist Drop

## TL;DR

A rare case of wrist drop caused by a stroke highlights the importance of considering stroke in unusual neurological presentations.

## Contribution

This case report adds to the understanding of atypical stroke presentations with isolated wrist drop.

## Key findings

- Isolated wrist drop can be a rare manifestation of acute ischemic stroke.
- MRI confirmed a brain infarct despite a normal CT scan in this case.
- The patient improved with antiplatelet therapy, statins, and physiotherapy.

## Abstract

Isolated wrist drop as a presentation of stroke is uncommon and may pose a diagnostic dilemma. We present a case of a 65-year-old man with hypertension and diabetes who presented with sudden-onset weakness of the left hand and inability to extend fingers, without any other focal neurological deficits. Noncontrast computed tomography of the head was normal. However, diffusion-weighted magnetic resonance imaging of the brain revealed an acute ischemic infarct involving the right frontoparietal and occipital lobes. A diagnosis of isolated left-sided wrist drop secondary to acute ischemic stroke was made. The patient showed clinical improvement with antiplatelet and statin therapy, along with physiotherapy, on follow-up. Although rare, isolated wrist drop may be a manifestation of stroke, and clinicians must remain vigilant to avoid diagnostic delays and to administer appropriate treatment in a timely manner.