Intracerebral hemorrhage in the precentral gyrus can present as isolated shoulder palsy, mimicking peripheral nerve or cervical spine lesions.
Isolated shoulder palsy warrants central imaging to avoid misdiagnosis as peripheral disease; first ICH report extends known etiologies and leaves open prevalence.
A small cortical infarction confined to the medial location of the precentral knob on the precentral gyrus may cause isolated shoulder palsy. However, there are no reports indicating intracerebral hemorrhage as a cause of isolated shoulder palsy. We herein report the case of a 48-year-old man who presented with isolated shoulder palsy as an initial symptom of subcortical hemorrhage at the precentral gyrus. Such cases may be easily misdiagnosed as shoulder or cervical spine problems. The distribution of muscle weakness is the key to an accurate diagnosis.
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Kanbayashi et al. (2017) studied this question.
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