wrist drop: acute ischemic stroke or radial nerve palsy or both

Stroke has many different symptoms, isolated hand weakness is the rarest one. even less common are concomitant radial nerve lesions and ischemic stroke that leads to isolated hand weakness. we report a patient with sudden onset of right wrist drop mimicking radial nerve palsy, found to be due to a acute cerebral infarct and radial nerve palsy in the same time. a well-taken history of the patient's illness and thorough clinical examination can differentiate stroke from peripheral neuropathy as the cause of hand weakness. modern neuroradiological methods such as brain msct or mri can quickly and reliably indicate the etiology of a neurological disease. in every patient who presents with isolated arm weakness, and for whom we are not sure whether it is a lesion of the central or peripheral nervous system, cerebral infarction must be included as a critical differential diagnosis because it can divert attention from sometimes harmful thrombolytic therapy.