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Isolated hemiataxia after supratentorial brain infarction
G J Luijckx1, J Boiten, J Lodder
1Department of Neurology, University Hospital Maastricht, State University of Limburg, The Netherlands.
Journal of Neurology, Neurosurgery, and Psychiatry
|June 1, 1994
Summary
Acute isolated hemiataxia, typically from cerebellar stroke, can rarely result from supratentorial stroke. This study identifies lacunar infarcts in the internal capsule as a novel cause of this rare stroke syndrome.
Area of Science:
- Neurology
- Stroke Medicine
- Neuroanatomy
Background:
- Acute isolated hemiataxia is predominantly associated with infratentorial (cerebellar) strokes.
- Supratentorial stroke-induced hemiataxia is exceptionally rare, with only two prior documented cases involving thalamic infarction and capsular hemorrhage.
Observation:
- Three new cases of isolated hemiataxia following supratentorial brain infarcts were observed over five years among 899 patients.
- Clinical presentation mimicked cerebellar hemiataxia.
- Neuroimaging (CT and MRI) revealed small, deep (lacunar) infarcts.
Findings:
- Two patients had infarcts confined to the posterior limb of the internal capsule, a previously unreported location for isolated hemiataxia.
- The third patient presented with a thalamic infarct extending into the adjacent posterior internal capsule.
- These findings suggest cerebellar pathways traverse the posterior aspect of the internal capsule.
Implications:
- Isolated hemiataxia after supratentorial stroke is an exceedingly rare clinical syndrome.
- The posterior limb of the internal capsule is identified as a critical, previously unrecognized site for causing cerebellar-type hemiataxia via lacunar infarcts.
- This confirms the anatomical separation of cerebellar pathways from motor and sensory tracts within the internal capsule.