Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 61 8 2024 02 13 488 491 Barbara Marčić Department of Histology, School of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina Ljiljana Marčić Department of Radiology, Polyclinic Medikol, Split, Croatia Marino Marcic Medical University of SplitClinical hospital center Split,Department of neurology 2021 01 27 2023 01 21 Stroke has many different symptoms, isolated hand weakness is the rarest one. Even less common are concomitant radial nerve lesions and ischemic stroke that leads to isolated hand weakness. We report a patient with sudden onset of right wrist drop mimicking radial nerve palsy, found to be due to a acute cerebral infarct and radial nerve palsy in the same time. A well-taken history of the patient's illness and thorough clinical examination can differentiate stroke from peripheral neuropathy as the cause of hand weakness. Modern neuroradiological methods such as brain MSCT or MRI can quickly and reliably indicate the etiology of a neurological disease. In every patient who presents with isolated arm weakness, and for whom we are not sure whether it is a lesion of the central or peripheral nervous system, cerebral infarction must be included as a critical differential diagnosis because it can divert attention from sometimes harmful thrombolytic therapy. https://acta.tums.ac.ir/index.php/acta/article/view/9125 https://acta.tums.ac.ir/index.php/acta/article/download/9125/5828