Chorea as the First Manifestation of Cerebral Infarction

Area of Science:

• Neurology
• Neuroscience
• Movement Disorders

Background:

• Cerebrovascular disease (CVD) typically presents as focal neurological deficits.
• Movement disorders are an unusual manifestation of CVD, accounting for 1% of cases.
• Striatal lesions are implicated in hemichorea, though movement disorders are disproportionately rare.

Observation:

• A 37-year-old woman presented with choreic movements as the initial symptom of an acute stroke.
• Computed tomography revealed a cortical/subcortical lesion in the right middle cerebral artery territory.

Findings:

• Basal ganglia infarcts are known to cause hemichorea.
• Despite the frequency of basal ganglia infarcts, movement disorders are disproportionately rare.
• The patient's symptoms showed complete remission over six weeks.

Implications:

• This case underscores that cerebrovascular disease can manifest as movement disorders.
• Early recognition of stroke-induced movement disorders is crucial for timely intervention.
• The generally good prognosis and spontaneous remission in most cases offer a positive outlook.