{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T01:00:20Z","timestamp":1783040420396,"version":"3.54.6"},"reference-count":67,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,2,13]],"date-time":"2024-02-13T00:00:00Z","timestamp":1707782400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>The cortical hand knob region of the brain is a knob-like segment of the precentral gyrus, projecting into the middle genu of the central sulcus. This anatomic landmark is responsible for intricate control of hand motor movements and has often been implicated in motor weakness following stroke. In some instances, damage to this area has been mistaken for peripheral causes of hand weakness. Our article aims to consolidate clinically relevant information on the cortical hand knob area in a comprehensive review to guide clinicians regarding diagnosis and treatment strategies. We conducted a systematic search within the Medline\/PubMed database for reports of strokes in the cortical hand knob region. All studies were published electronically up until December 2023. The search was conducted using the keyword \u201chand knob\u201d. A total of 24 reports containing 150 patients were found. The mean and median ages were 65 and 67 years, respectively. Sixty-two percent of the individuals were male. According to the TOAST criteria for the classification of the stroke, 59 individuals had a stroke due to large-artery atherosclerosis, 8 had small-vessel occlusion, 20 had cardioembolism, 25 were determined, and 38 were undetermined. The most common etiologies for stroke in the hand knob area can be attributed to large vessel occlusions, small vessel occlusions, or cardioembolism. Presentations following damage to this area can mimic ulnar, median, or radial neuropathy as well. Our comprehensive review serves as a resource for recognizing and managing stroke in the cortical hand knob area.<\/jats:p>","DOI":"10.3390\/medicina60020318","type":"journal-article","created":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T04:18:22Z","timestamp":1707884302000},"page":"318","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["A Narrative Review of Stroke of Cortical Hand Knob Area"],"prefix":"10.3390","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6179-2177","authenticated-orcid":false,"given":"Jamir Pitton","family":"Rissardo","sequence":"first","affiliation":[{"name":"Neurology Department, Cooper University Hospital, Camden, NJ 08103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6104-6904","authenticated-orcid":false,"given":"Vishnu Vardhan","family":"Byroju","sequence":"additional","affiliation":[{"name":"Neurology Department, Cooper University Hospital, Camden, NJ 08103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sushni","family":"Mukkamalla","sequence":"additional","affiliation":[{"name":"Cooper Medical School of Rowan University, Camden, NJ 08103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8024-2354","authenticated-orcid":false,"given":"Ana Let\u00edcia Fornari","family":"Caprara","sequence":"additional","affiliation":[{"name":"Medicine Department, Federal University of Santa Maria, Santa Maria 97105-900, RS, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1007\/s002340050745","article-title":"Monoparesis of the right hand following a localised infarct in the left \u201cprecentral knob\u201d","volume":"41","author":"Tei","year":"1999","journal-title":"Neuroradiology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1143","DOI":"10.1212\/WNL.57.6.1143","article-title":"Infarction of the \u201chand knob\u201d area","volume":"57","author":"Back","year":"2001","journal-title":"Neurology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1589","DOI":"10.1212\/WNL.57.9.1589","article-title":"A diffusion-weighted MRI study of acute ischemic distal arm paresis","volume":"57","author":"Gass","year":"2001","journal-title":"Neurology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1423","DOI":"10.1007\/s00415-008-0930-7","article-title":"Small cortical stroke in the\" hand knob\" mimics anterior interosseous syndrome","volume":"255","author":"Granziera","year":"2008","journal-title":"J. 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