title: Reversible striatal hypermetabolism in chorea associated with moyamoya disease: a report of two cases.
abstract: BACKGROUND
  The pathophysiological mechanism of chorea as a presentation of pediatric moyamoya disease remains unknown, although ischemia is suspected as a likely cause. The authors describe two cases of pediatric moyamoya disease, both of which presented with hemichorea in the stable phase after successful bypass surgery.
  
  
  METHODS
  Cerebral blood flow was almost normal in one case and decreased in the basal ganglia and watershed area in the other case due to infarcts occurring before surgery. In both cases,18F-fluorodeoxyglucose positron emission tomography revealed elevated glucose metabolism in the corresponding side of the striatum, which reverted to normal after recovery from chorea. Magnetic resonance angiography revealed a dilated and extended lenticulostriate artery at the exact site of the hypermetabolic lesion.
authors.affiliation: Department of Neurosurgery, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Sugita
authors.affiliation: Department of Neurosurgery, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan. tfunaki@kuhp.kyoto-u.ac.jp.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Funaki
authors.affiliation: Department of Neurosurgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
authors.forename: Jun C
authors.initials: JC
authors.lastname: Takahashi
authors.affiliation: Department of Neurosurgery, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Takagi
authors.affiliation: Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Fushimi
authors.affiliation: Department of Neurosurgery, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kikuchi
authors.affiliation: Department of Neurosurgery, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
authors.forename: Kazumichi
authors.initials: K
authors.lastname: Yoshida
authors.affiliation: Department of Neurosurgery, Fukui Red Cross Hospital, Fukui, Japan.
authors.forename: Taketo
authors.initials: T
authors.lastname: Hatano
authors.affiliation: Department of Neurosurgery, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
authors.forename: Natsuhi
authors.initials: N
authors.lastname: Sasaki
authors.affiliation: Department of Neurosurgery, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Miyamoto
mesh_terms: D000293:Adolescent; D002648:Child; D002819:Chorea / Q000209:etiology* / Q000378:metabolism; D003342:Corpus Striatum / Q000378:metabolism*; D005260:Female; D006801:Humans; D009072:Moyamoya Disease / Q000150:complications* / Q000378:metabolism; D059906:Neuroimaging
keywords: Chorea; Direct bypass; Moyamoya disease