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Focal asterixis caused by a small putaminal hemorrhage
J M Trejo1, S Giménez-Roldán, A Esteban
1Department of Neurology, Hospital Provincial, Madrid, Spain.
Summary
A small putaminal hemorrhage caused reversible motor deficits and persistent asterixis in a hypertensive man. This suggests altered brain signals affecting postural tone maintenance.
Area of Science:
- Neurology
- Neuroscience
- Clinical Medicine
Background:
- Putaminal hemorrhage is a type of stroke affecting the basal ganglia.
- Hypertension is a major risk factor for hemorrhagic stroke.
- Asterixis, or flapping tremor, can indicate metabolic or structural brain dysfunction.
Observation:
- A 74-year-old hypertensive male presented with unilateral asterixis and pure motor hemiparesis.
- The motor deficits were contralateral to a small putaminal hemorrhage.
- The hemiparesis resolved quickly, but asterixis persisted.
Findings:
- Focal asterixis can be an isolated sign of intracranial hemorrhage.
- The putamen's role in motor control and its connection to thalamic circuits is highlighted.
- This case implicates striopallidal pathways in the generation of asterixis.
Implications:
- Altered inhibitory input from the striopallidum to the thalamus may disrupt postural tone.
- Understanding these specific neurocircuitry disturbances can refine stroke diagnosis and management.
- This case contributes to the understanding of basal ganglia stroke syndromes and their clinical manifestations.