Generalized chorea due to bilateral small, deep cerebral infarcts

Area of Science:

• Neurology
• Neuroimaging
• Cerebrovascular Diseases

Background:

• Chorea is a movement disorder characterized by involuntary, irregular, and purposeless movements.
• Lacunar infarcts are small ischemic strokes occurring in the deep brain structures.
• The diagnostic sensitivity of neuroimaging modalities for small deep cerebral infarcts remains an area of clinical interest.

Observation:

• A patient presented with generalized chorea.
• Magnetic resonance imaging (MRI) revealed bilateral lacunar infarcts affecting the caudate nucleus, putamen, and deep frontal white matter.
• Computed tomography (CT) was also performed for comparison.

Findings:

• The patient experienced complete recovery from chorea.
• MRI demonstrated superior sensitivity in identifying the small, deep cerebral infarcts compared to CT.
• The infarcts were localized to specific deep brain nuclei crucial for motor control.

Implications:

• This case highlights the potential for complete recovery from chorea caused by lacunar infarcts.
• It underscores the diagnostic advantage of MRI over CT in detecting small, deep cerebral infarcts.
• Understanding the neuroanatomical basis of stroke-induced movement disorders is critical for effective management.