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Hemichorea associated with ipsilateral chronic subdural hematoma--case report
M Yoshikawa1, M Yamamoto, K Shibata
1Department of Neurosurgery, Matsue Red Cross Hospital, Japan.
Neurologia Medico-Chirurgica
|September 1, 1992
Summary
Sudden hemichorea in a patient with subdural hematoma (SDH) was linked to contralateral cerebral hemisphere infarction. Prompt SDH removal resolved hemichorea, highlighting the importance of assessing pre-existing ischemic lesions.
Area of Science:
- Neurology
- Neuroimaging
- Vascular Neurology
Background:
- Subdural hematoma (SDH) can cause neurological deficits.
- Hemichorea is a rare hyperkinetic movement disorder.
Observation:
- A 73-year-old male presented with sudden left-sided hemichorea.
- CT revealed a left SDH and right cerebral infarction (corona radiata, temporo-occipital).
- Hemichorea resolved post-SDH evacuation.
Findings:
- Postoperative SPECT showed reduced perfusion in the right cerebral hemisphere.
- Angiography revealed severe stenosis of the right middle cerebral artery.
- This suggests reduced cerebral blood flow, exacerbated by SDH, caused hemichorea.
Implications:
- This case highlights the importance of evaluating contralateral ischemic lesions in patients with SDH-associated hemichorea.
- Early diagnosis and management of underlying cerebrovascular disease are crucial.
- Understanding the interplay between SDH and pre-existing vascular compromise is key for neurological recovery.
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