Differential Diagnosis for Right Sided Hemiparesis
Single Most Likely Diagnosis
- Ischemic Stroke: This is the most common cause of sudden onset hemiparesis, resulting from a blockage of a cerebral artery, leading to damage of the brain tissue due to lack of blood supply.
Other Likely Diagnoses
- Intracerebral Hemorrhage: Bleeding within the brain tissue can cause hemiparesis, often presenting with sudden onset of symptoms, including headache and altered consciousness.
- Traumatic Brain Injury: Head trauma can result in hemiparesis due to injury of the brain tissue, including contusions, lacerations, or hemorrhages.
- Brain Tumor: Both primary and metastatic brain tumors can cause hemiparesis by compressing or infiltrating the motor pathways of the brain.
Do Not Miss Diagnoses
- Subarachnoid Hemorrhage: Although less common, this condition, often due to aneurysmal rupture, can present with sudden severe headache and hemiparesis, and is critical to diagnose promptly due to high morbidity and mortality.
- Cervical Spine Injury: High cervical spine injuries can cause hemiparesis or quadriparesis due to spinal cord compression or injury, and are critical to diagnose to prevent further injury.
- Meningitis or Encephalitis: Infections of the brain and meninges can cause hemiparesis, among other symptoms, and require prompt diagnosis and treatment to prevent serious complications.
Rare Diagnoses
- Multiple Sclerosis: An autoimmune disease that can cause demyelination of the central nervous system, leading to a variety of neurological symptoms, including hemiparesis, though this is less common as a presenting symptom.
- Acute Disseminated Encephalomyelitis (ADEM): A rare autoimmune disease that can cause widespread demyelination of the brain and spinal cord, leading to symptoms including hemiparesis.
- Mitochondrial Encephalomyopathy, Lactic Acidosis, and Stroke-like episodes (MELAS): A rare genetic disorder that can cause stroke-like episodes, including hemiparesis, due to mitochondrial dysfunction.