Early diagnosis by diffusion-weighted MRI of pure motor stroke limited to finger weakness

Pure motor neurologic deficits occur among 3%-14% of all patients with ischemic stroke. Pure motor monoparesis occurs among 2%-22% of patients with pure motor stroke. The authors report the case of a 73-year-old woman with isolated finger weakness as the sole manifestation of a small cortical-subcortical pure motor stroke diagnosed within 4 hours of onset by means of diffusion-weighted echo-planar magnetic resonance imaging. To the authors' knowledge, the case of a patient with pure motor stroke with finger weakness as the only manifestation has not been previously reported. Increased awareness of this rare clinical presentation of pure motor stroke coupled with the promise of prompt diagnosis by means of diffusion-weighted MRI should lead to earlier stroke intervention.