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-isop...

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Bibliographic Details
Published in:	Journal of neurosurgery Vol. 105; no. 1; pp. 142 - 147
Main Authors:	Morigaki, Ryoma, Uno, Masaaki, Suzue, Atsuhiko, Nagahiro, Shinji
Format:	Journal Article
Language:	English
Published:	United States 01-07-2006
Subjects:	Aged Brain Ischemia - complications Brain Ischemia - diagnosis Brain Ischemia - surgery Carotid Artery, Internal Carotid Stenosis - complications Carotid Stenosis - diagnosis Carotid Stenosis - surgery Chorea - etiology Endarterectomy, Carotid Female Humans Male
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Summary:	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.
Bibliography:	ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Report-1 ObjectType-Article-3
ISSN:	0022-3085
DOI:	10.3171/jns.2006.105.1.142