Sakashita Y, Kakuta K, Kakuma K, Matsuda H
Department of Neurology, Tonami General Hospital.
Rinsho Shinkeigaku. 1992 Apr;32(4):454-6.
A 64-year-old right hemiplegic woman, who had been treated for hypertension for 15 years, was admitted to our hospital. Neurologic examination on admission disclosed right hemiplegia and motor aphasia; however, ophthalmoparesis, pupillary abnormality, and blepharoptosis were not evident. Excessive sweating on the right side of the body, which was most marked on the face, was observed. Amount of sweating on the left side of the body was normal. Unilateral hyperhidrosis persisted for more than 2 months. MRI revealed hemorrhagic infarctions in the left basal ganglia, internal capsule, thalamus, hypothalamus, and medial part of the cerebral peduncle. 123I-IMP SPECT disclosed hypoperfusion in the left striatum, thalamus, occipital cortex, and right cerebellar hemisphere. Cerebral angiography revealed arteriosclerotic changes in the basilar artery, but that the left posterior cerebral artery and its branches were not occluded. Unilateral persistent hyperhidrosis is rare after ischemic stroke. Hypothalamic lesion was thought to be responsible for the hyperhidrosis in this patient. As the hypothalamus receives its blood supply from the posterior cerebral artery, unilateral persistent hyperhidrosis may be an important sign of cerebral infarction in the posterior cerebral artery region.
一名64岁的右侧偏瘫女性，患有高血压15年，入住我院。入院时神经系统检查发现右侧偏瘫和运动性失语；然而，眼肌麻痹、瞳孔异常和上睑下垂并不明显。观察到身体右侧出汗过多，面部最为明显。身体左侧出汗量正常。单侧多汗持续超过2个月。MRI显示左侧基底节、内囊、丘脑、下丘脑和大脑脚内侧有出血性梗死。123I-IMP SPECT显示左侧纹状体、丘脑、枕叶皮质和右侧小脑半球灌注不足。脑血管造影显示基底动脉有动脉硬化改变，但左侧大脑后动脉及其分支未闭塞。缺血性中风后单侧持续性多汗很少见。下丘脑病变被认为是该患者多汗的原因。由于下丘脑的血液供应来自大脑后动脉，单侧持续性多汗可能是大脑后动脉区域脑梗死的重要体征。
