Early recurrence of spectacular shrinking deficit as a form of presentation in a cardio-embolic infarct

Introduction. Spectacular shrinking deficit (SSD) is a little known neurovascular syndrome with a monophasic clinical course. It was observed in 4.8% (11 of 231 patients) with cardio-embolic cerebral infarcts in the records of patients with cerebrovascular disease at our hospital. Clinical case. We present the only patient in our records (0.04% of the cardio-embolic infarcts and 0.06% of the patients in the series, which consists of 1,500 consecutive patients with stroke studied over a period of 8 years) with recurrent SSD, which was the form of presentation of rheumatic mitral valve disease with atrial fibrillation. Discussion. As far as we know, the recurrent clinical course of SSD has not previously been described. The clinical case presented shows that early recur recurrence is possible in SSD. Conclusions. The possibility of the presentation of a cerebral infarct of cardioembolic origin in the form of recurrent SSD should be borne in mind. Early recurrence of SSD should also be taken into account to avoid bias in selecting patients for clinical trials to be carried out during the acute phase of cerebrovascular disease [REV NEUROL 1998; 27: 601-3].