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[Vascular hemichorea: clinical-radiological correlation].
R Galiano1, J Juni, A Castillo
1Servicio de Neurología, Hospital General Universitario de Valencia, España.
Revista De Neurologia
|April 25, 2000
Summary
Hemichorea, a rare condition in stroke, is linked to basal ganglia lesions. Imaging, particularly MRI, helps identify these lesions, though some remain undetected by conventional methods.
Area of Science:
- Neurology
- Neuroimaging
- Vascular Neurology
Background:
- Hemichorea is an uncommon manifestation of acute cerebrovascular accidents.
- Lesions in the basal ganglia, especially the striate nucleus, are associated with hemichorea.
- Advanced neuroimaging techniques like Magnetic Resonance (MR) are crucial for detecting small lesions.
Observation:
- A retrospective study analyzed 10 patients with vascular-related hemichorea between 1993 and 1999.
- Cerebral CT and/or MR imaging were used to identify lesion sites.
- The average patient age was 72.5 years.
Findings:
- Eighty percent of patients (8/10) had lesions in the basal ganglia, equally split between ischemic and hemorrhagic types.
- Specific lesion sites included the caudate nucleus (10%), thalamus (20%), and capsulo-lenticular regions (50%).
- Most lesions were contralateral to the affected body side, with one exception of a left thalamic hematoma causing homolateral hemichorea.
Implications:
- Lesion sites associated with hemichorea are diverse.
- Conventional neuroimaging failed to detect lesions in 20% of cases.
- This suggests a functional basal ganglia network that can be disrupted at multiple points, leading to similar clinical presentations.