Sudden-onset abulia and alien hand syndrome: Lightning strik
The following case has been reported in the journal Neurology. A 47-year-old man developed sudden-onset abulia and alien hand syndrome (AHS).

MRI revealed bilateral ischemic injury within anterior cerebral artery territory (a complex bilateral corpus callosum infarction1) due to obstruction of a variant bihemispheric A2 branch by a thrombus also demonstrated on 3D volume-rendered CT angiography.

The finding of lower-limb deep venous thrombosis in a patient with right-to-left interatrial shunt accounted for the case, given workup was otherwise unremarkable.

Key takeaway:-
This case is unique for paradoxical embolization of a variant artery (prevalence 2%–7%) that led to a complex bilateral corpus callosum infarction presenting with AHS

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