Neck pain and absence of cranial nerve symptom are clues of cervical myelopathy mimicking stroke: Two case reports

Table 1 Patients with cervical myelopathy mimicking ischemic stroke in the literature

Ref.	Age/Sex	Initial symptoms	Neck pain	Cranial nerve symptoms	Initial diagnosis	Final diagnosis	Initial treatment	Outcomes
Lobitz and Grate[52], 1995	85/F	Neck pain and right hemiparesis	Yes	No	SEH	SEH	Corticosteroids	Improved after surgery
Marinella and Barsan[51], 1996	60/F	Neck pain and left hemiparesis	Yes	No	SEH	SEH	Conservative treatment	Improved
Sakamoto et al[50], 2003	75/F	Neck pain and right hemiparesis	Yes	No	Ischemic stroke	SEH	Antiplatelet therapy	Improved after surgery
Adamson et al[49], 2004	66/M	Neck pain and right hemiparesis	Yes	No	TIA	SEH	Heparin	Improved after surgery
Lin[48], 2004	82/F	Neck pain and right hemiparesis	Yes	Equivocal facial palsy	SEH	SEH	Intubated and resuscitated	Died of respiratory sepsis
Hsieh et al[47], 2006	65/M	Right hemiparesis	Yes	NA	Ischemic stroke	SEH	Heparin	Improved after surgery
D’Souza et al[46], 2008	62/M	Right hemiparesis	Interscapular pain	No	Ischemic stroke	SEH	IVT	Improved after surgery
Ishikawa et al[45], 2008	82/M	Neck pain and left hemiparesis	Yes	No	SEH	SEH	Surgery	Improved
Ofluoğlu et al[44], 2009	63/M	Neck pain and right hemiparesis	Yes	No	Cerebrovascular accident	SEH	Surgery	Improved
Wang et al[43], 2009	69/M	Neck pain and right hemiparesis	Yes	NA	Ischemic stroke	SEH	Heparin	Improved after surgery
Nakanishi et al[42], 2011	73/F	Neck pain and left hemiparesis	Yes	No	SEH	SEH	Surgery	Improved after surgery
	62/M	Neck pain and numbness of the right lower extremity	Yes	No	SEH	SEH	Surgery	Improved after surgery
	60/F	Neck pain and left hemiparesis	Yes	NA	SEH	SEH	Conservative treatment	Improved
Lee et al[41], 2011	58/F	Quadriparesis and neck pain	Yes	NA	SEH	SEH	Surgery	Improved after surgery
Lemmens et al[40], 2012	66/F	Interscapular pain and right hemiparesis	Interscapular pain	No	Ischemic stroke	SEH	Antihypertensive drugs	Improved
Liou et al[15], 2012	60/F	Neck pain, dizziness, and right hemiparesis	Yes	No	Ischemic stroke	SEH	Surgery	No significant improvement after surgery
	58/F	Neck pain and right hemiparesis	Yes	No	Ischemic stroke	SEH	Megadose steroid therapy	Improved
Matsumoto et al[39], 2012	71/F	Neck pain and right hemiparesis	Yes	No	Ischemic stroke	SEH	Steroids and glycerine	Improved
	54/F	Neck pain and right hemiparesis	Yes	No	Ischemic stroke	SEH	Conservative treatment	Improved
Son et al[38], 2012	63/M	Left lower extremityweakness	Yes	Mild dysarthria	Anterior spinal artery syndrome	SEH	IVT	Improved after surgery
Shima et al[37], 2012	84/F	Neck pain and right hemiparesis	Yes	No	SEH	SEH	Conservative treatment	Improved
Bailey et al[36], 2012	62/M	Neck pain and right hemiparesis	Yes	No	SEH	SEH	Surgery	NA
Schmidley et al[12], 2013	96/F	Neck pain and left hemiparesis	Yes	Mild droop in the left nasolabial fold	Ischemic stroke	SEH	Surgery	Improved after surgery
	81/F	Neck pain and right hemiparesis	Yes	No	Ischemic stroke	SEH	Aspirin	Improved after surgery
Park et al[35], 2013	69/M	Weakness in the right upper extremity	NA	NA	TIA	SDH	Aspirin	Improved after surgery
Terabe et al[34], 2015	61/F	Neck pain, paralysis and numbness in the left upper limb	Yes	No	Ischemic stroke	SEH	Argatroban hydrate	Improved after surgery
Buyukgol et al[33], 2015	58/M	Neck pain and right hemiparesis	Yes	NA	SEH	SEH	Antiedema treatment	Improved
Morimoto et al[32], 2016	71/M	Left hemiparesis	Yes	NA	Ischemic stroke	SEH	IVT	Improved after surgery
Patel et al[31], 2018	51/M	Neck pain, right hemiparesis, and drooping of right side eyelids	Yes	No	Ischemic stroke	SEH	IVT	Improved after surgery
Romaniuc et al[26], 2018	74/M	Left hemiparesis	Left shoulder pain	No	Ischemic stroke	SEH	Surgery	Improved after surgery
Tsou et al[30], 2019	83/M	Left hemiparesis	No	No	Ischemic stroke	Atlantoaxial dislocation	IVT	Improved after surgery
Emamhadi et al[29], 2019	77/F	Left hemiparesis	Neck pain irradiating inboth shoulders	No	Ischemic stroke	SEH	Enoxaparin and aspirin	Improved after surgery
Chen et al[28], 2020	52/M	Unilateral weakness of the limbs	Right arm pain	No	SEH	SEH	Dexamethasone	Improved
Inatomi et al[27], 2020	65/F	Right back pain and right hemiparesis	Right back pain	No	SEH	SEH	Rest and administration of analgesics	Improved
	78/F	Neck pain and left hemiparesis	Yes	No	SEH	SEH	Rest using a neck collar and administration of analgesics	Improved
	79/M	Occipital pain and lefthemiparesis	Occipital pain	Anisocoria and mild dysarthria	SEH	SEH	Rest using a neck collar andadministration of analgesics;	Improved
	63/F	Occipital and neck pain, and left hemiparesis	Occipital and neck pain	Mild dysarthria	SEH	SEH	Rest and administration of analgesics	Improved
	64/M	Neck pain and left hemiparesis	Yes	No	SEH	SEH	Surgery	Improved
Teles et al[25], 2020	63/F	Neck and left shoulder pain, and right side hemiparesis	Yes	NA	Ischemic stroke	SEH	IVT	No significant improvement after surgery
Huang et al[24], 2020	54/F	Neck pain, right facial numbness, and right hemiparesis	Yes	No	Ischemic stroke	SEH	IVT	Improved after surgery
Rahangdale et al[23], 2020	67/M	Right hemiparesis and hemianesthesia	NA	NA	Ischemic stroke	SEH	IVT	Improved after cryoprecipitate
Szeto et al[22], 2021	61/F	Neck pain and left hemiparesis	Yes	No	Ischemic stroke	SEH	IVT	Improved after conservative treatment
	58/M	Left hemiparesis	No	No	Ischemic stroke	SEH	IVT	Improved after surgery
Tay et al[21], 2021	77/F	Right hemiparesis	No	No	Ischemic stroke	SEH	Surgery	Improved
This study	76/F	Right hemiparesis	Yes	No	Ischemic stroke	SEH	Surgery	Improved
	57/M	Right leg monoplegia	Yes	No	Ischemic stroke	Cervical metastatic carcinoma	Chemotherapy	Deteriorated

IVT: Intravenous thrombolysis; NA: Not available; SDH: Subdural spinal hematoma; SHE: Spinal epidural hematoma; TIA: Transient ischemic attack.