Atrophic cerebral peduncle may be a hallmark for evaluating the compensatory ability of the contralateral hemisphere

Hemorrhagic mirror stroke is a rare subtype of recurrent hemorrhagic stroke, similar to a cerebral hemorrhage in mirror position of the contralateral hemisphere. Here report two cases of hemorrhagic mirror stroke in the nondominant hemisphere of a right-handed man and a left-handed woman several years after the first similar onset in the dominant one. During rehabilitation after the first-time stroke, patients showed excellent recovery despite the development of atrophy in the cerebral peduncle on the affected side and aphasia and quadriplegia after the mirror stroke in the nondominant hemisphere. These cases not only highlight some uncommon clinical symptoms or the rare stroke type but also demonstrate the association between recovery of patients with atrophic cerebral peduncle after stroke and functional reorganization in the undamaged hemisphere.