Hand Knob Area Infarct Following Primary Percutaneous Coronary Intervention: A Case Report

Percutaneous coronary intervention (PCI) is a common procedure following an acute myocardial infarction. Periprocedural stroke is a rare but life-threatening complication. Among these hand knob area infarctions are rarely encountered. Interestingly, the clinical presentation of these patients mimic a peripheral nerve injury making it a diagnostic challenge. We report a 57-year-old gentleman who noticed finger drop with hand muscle weakness of the right upper limb immediately following PCI which was carried out via a radial arterial puncture. Brain imaging revealed an infarction involving the hand knob area and he was treated with antiplatelets, statins and physiotherapy. This case highlights the importance of having a high degree of suspicion for the diagnosis of a hand knob area infarction when a patient present with a clinical presentation suggestive of a radial nerve palsy.