Hemichorea due to hemodynamic ischemia associated with extracranial carotid artery stenosis. Report of two cases.
In this paper the authors describe two patients with recurrent hemiparesis and limb shaking that gradually progressed to hemichorea. Cerebral angiography confirmed severe unilateral internal carotid artery stenosis (95%) contralateral to the hemichorea. The cerebral blood flow, assessed using N-isopropyl-p-(iodine-123) iodoamphetamine single-photon emission computed tomography (SPECT), disclosed markedly decreased vascular reserves in both patients. After carotid endarterectomy was performed, the hemichorea gradually subsided and SPECT confirmed increased cerebral perfusion. The results in these cases indicate that surgical revascularization is effective for hemichorea due to cerebral ischemia with reduced vascular reserve.
Morigaki
Ryoma
R
Department of Neurosurgery, Faculty of Medicine, The University of Tokushima, Japan.
Uno
Masaaki
M
Suzue
Atsuhiko
A
Nagahiro
Shinji
S
D000368:Aged; D002545:Brain Ischemia / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D002343:Carotid Artery, Internal; D016893:Carotid Stenosis / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D002819:Chorea / Q000209:etiology*; D016894:Endarterectomy, Carotid; D005260:Female; D006801:Humans; D008297:Male