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To the Editor:
We read with interest the article by Kim et al.1 concerning a series of six patients with pure dysarthria with or without other minimal neurologic signs due to small cortical strokes. Here we report two additional cases in which FLAIR and diffusion-weighted MRI (DWI) identified small cortical infarctions.
Case 1: A 63-year-old right-handed woman was admitted for sudden transient dysarthria with a minimal left central facial paresis that lasted approximately 10 hours. She had a history of arterial hypertension and breast cancer. She was on enalapril 10 mg/day and tamoxifen. The neurologic examination demonstrated moderate dysarthria with a mild left lower facial paresis without compromising tongue motility. Cervical doppler ultrasound, transesophageal echocardiogram, and brain CT scan had normal results. A brain MRI performed 24 hours after the onset of the neurologic symptoms showed a cortical lesion with hyperintense signal on FLAIR and proton …
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