Case Report: Asymmetric recovery unmasking watershed infarction in a patient with ICU-acquired weakness - Takeaways - MDSpire

Case Report: Asymmetric recovery unmasking watershed infarction in a patient with ICU-acquired weakness

  • By

  • Bingqing Zhao

  • Meng Yu

  • Peining Zhou

  • Fan Li

  • Junfang Huang

  • Jing Ma

  • Zhaoxia Wang

  • June 24, 2026

  • 0 min

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  • 1

    A 59-year-old female developed profound muscle weakness after severe pneumonia and septic shock, initially diagnosed as ICU-acquired weakness (ICUAW).

  • 2

    Electrophysiological studies and muscle biopsy supported the ICUAW diagnosis, but the patient showed asymmetric motor recovery with persistent left-sided deficits.

  • 3

    Cranial MRI revealed fresh watershed infarctions in the right hemisphere, indicating concurrent neurological complications in the patient.

  • 4

    A tailored rehabilitation strategy focusing on mitochondrial metabolism and active physical therapy led to significant functional improvement.

  • 5

    This case emphasizes the need for clinicians to suspect asymmetric recovery patterns in ICUAW and the importance of a multimodal approach for diagnosis and management.

Original Source(s)

Case Report: Asymmetric recovery unmasking watershed infarction in a patient with ICU-acquired weakness

  • by Bingqing Zhao, Meng Yu, Peining Zhou, Fan Li, Junfang Huang, Jing Ma, Zhaoxia Wang

  • June 24, 2026

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