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Transient hemiballism, a movement disorder, can indicate significant cerebral artery disease. This symptom suggests potential blockages in arteries supplying the brain, highlighting the need for prompt diagnosis.
Area of Science:
- Neurology
- Vascular Neurology
- Neuroscience
Background:
- Ischemic cerebrovascular disease can manifest with various neurological deficits.
- Transient dyskinesias, such as hemiballism, are uncommon but significant neurological signs.
Observation:
- Three patients with ischemic cerebrovascular disease presented with transient hemiballism.
- Angiography revealed occlusive disease in the cerebral arteries of all patients.
Findings:
- Two patients had contralateral carotid artery insufficiency (occlusion or stenosis) despite lesions in different cerebral arteries.
- One patient exhibited basilar artery occlusion.
Implications:
- Transient hemiballism may signal significant occlusive cerebrovascular disease.
- The dual blood supply to the subthalamic nucleus could explain hemiballism in cases of combined carotid and vertebral system insufficiency.
Abstract:
Three patients with ischemic cerebrovascular disease suffered attacks of transient dyskinesias, consistent with hemiballism. Angiographically all of them showed occlusive disease of the cerebral arteries. Two patients had lesions in different cerebral arteries, but showed signs and symptoms of insufficiency of the carotid artery contralateral to the dyskinesias, which was occluded in one patient and severely stenosed in the other. The third patient had frank occlusion of the basilar artery. The blood supply of the nucleus subthalamicus receiving contributions from the carotid and vertebral arterial system as well would explain transient hemiballism as a symptom of the insufficiency of both arterial systems and would further be one of the possible explanations for the low frequency of this symptom. On the other hand the appearance of transient hemiballism should be regarded as indicative of significant occlusive disease of the cerebral arteries.