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Generalized chorea associated with bilateral chronic subdural hematoma.

Yueh-Feng Sung1, Hsin-I Ma, Yaw-Don Hsu

  • 1Department of Neurology, Tri-Service General Hospital, Taipei, Taiwan, ROC.

European Neurology
|May 26, 2004
PubMed
Summary

A rare cause of chorea, chronic subdural hematoma, can lead to involuntary movements. Surgical removal of the hematoma resolved the patient's choreiform movements, suggesting brain compression as the cause.

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Area of Science:

  • Neurology
  • Neurosurgery
  • Radiology

Background:

  • Chorea is typically caused by various acquired disorders, including hypoxia-ischemia injury, drugs, toxins, infections, autoimmune, endocrine, and electrolyte abnormalities.
  • Subdural hematoma is an infrequent cause of chorea.

Purpose of the Study:

  • To report a rare case of generalized chorea caused by chronic subdural hematoma.
  • To investigate the potential mechanism linking subdural hematoma to chorea.

Main Methods:

  • A 76-year-old woman presented with sudden onset of generalized choreiform movements.
  • Computed tomography (CT) and magnetic resonance imaging (MRI) were used for diagnosis.
  • Surgical evacuation of the subdural hematoma was performed.

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Main Results:

  • Imaging revealed bilateral lateral convexity subdural effusion, confirmed as chronic subdural hematoma.
  • Following surgical evacuation, the patient's choreoathetoid movements ceased completely.

Conclusions:

  • Chronic subdural hematoma should be considered in the differential diagnosis of new-onset chorea.
  • Transient ischemia in bilateral subcortical regions, due to brain compression and distortion by the hematomas, is proposed as the mechanism for chorea in this case.