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[Generalized choreic movement associated with subarachnoid hemorrhage].

K Sakai1, K Kyoshima, Y Ohigashi

  • 1Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan.

No to Shinkei = Brain and Nerve
|September 1, 1991
PubMed
Summary

This case report details a rare instance of generalized choreic movement linked to subarachnoid hemorrhage. Surgical intervention for the aneurysm led to the complete resolution of choreic movements.

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Area of Science:

  • Neurology
  • Neurosurgery
  • Vascular Neurology

Background:

  • Subarachnoid hemorrhage (SAH) can lead to various neurological deficits.
  • Choreic movement disorders are uncommon complications of SAH.

Observation:

  • A 71-year-old woman presented with headache, followed by consciousness disturbance and generalized choreic movements.
  • Imaging revealed subarachnoid hemorrhage, ventricular dilatation, and lacunar infarcts in the basal ganglia, particularly the caudate nuclei.
  • Angiography identified an internal carotid-anterior choroidal artery aneurysm with vasospasm.

Findings:

  • The patient's choreic movements and altered consciousness improved significantly after surgical clipping of the aneurysm.
  • The chorea resolved completely within eight days post-operation.

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  • Post-operative MRI confirmed lacunar infarcts in the bilateral basal ganglia.

    • Implications:

    • This case suggests that impaired circulation in the basal ganglia, secondary to vasospasm and hydrocephalus following SAH, can cause choreic movement.
    • The findings highlight the potential for neurological recovery after treating the underlying vascular lesion.
    • This represents the first reported case of generalized choreic movement associated with SAH that resolved post-surgery.