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, depending on the location and size of the hemorrhage. It's a medical emergency requiring immediate attention.
- Traumatic Brain Injury: A head injury can cause hemiparesis if it results in damage to the motor areas of the brain on the left side (since the brain's right side controls the body's left side and vice versa).
- Brain Tumor: Both primary and metastatic brain tumors can cause hemiparesis by compressing or invading the motor pathways of the brain.
Do Not Miss Diagnoses
- Subarachnoid Hemorrhage: Although less common, a hemorrhage into the space surrounding the brain (subarachnoid space) can present with sudden severe headache and hemiparesis, and is a medical emergency.
- Cerebral Venous Thrombosis: A clot in the veins that drain blood from the brain can cause a stroke, leading to hemiparesis. This condition can be particularly dangerous in young women, especially those on oral contraceptives.
- Spinal Cord Compression: Compression of the spinal cord, often due to a tumor or disc herniation, can cause weakness or paralysis of the limbs, including hemiparesis if the compression affects the cervical spine.
Rare Diagnoses
- Multiple Sclerosis: An autoimmune disease that affects the brain and spinal cord, leading to a wide range of neurological symptoms, including hemiparesis, though this is less common as a presenting symptom.
- Acute Disseminated Encephalomyelitis (ADEM): A rare autoimmune disease characterized by a sudden, widespread attack of inflammation in the brain and spinal cord, which can cause hemiparesis among other symptoms.
- Moyamoya Disease: A rare condition caused by narrowing or blockage of the internal carotid artery and its branches, leading to reduced blood flow to the brain, which can cause hemiparesis, among other symptoms.