Aydin Sabri, Abuzayed Bashar, Kiziltan Gunes, Gunduz Aysegul, Yagci Selin, Mengi Murat, Kizilkilic Osman, Uzan Mustafa, Hanci Murat
Department of Neurosurgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
J Neurol Surg A Cent Eur Neurosurg. 2013 Jul;74(4):271-6. doi: 10.1055/s-0032-1322549. Epub 2013 Jan 14.
A 30-year-old man with brainstem cavernoma experienced hemorrhage and was operated in 2008. Six months after the operation, the patient presented with new complaints of left arm tremor namely Holmes' tremor. Neurological examination also revealed left-sided internuclear ophthalmoplegia, left-sided mild paresis, and increased deep tendon reflexes of the left upper extremity, truncal ataxia, and dysarthria. Brain magnetic resonance imaging showed a postoperative cavity and gliosis at the level of the superior and inferior colliculus in the right tegmentum and right red nucleus with extension to the substantia nigra. Fahn-Tolosa-Marin tremor rating scale (TRS) for his left upper extremity (Part A, score 6) was 11 for the proximal and the distal arm. After the failure of medical treatment, the patient underwent right globus pallidum internus and ventral intermediate thalamic nucleus deep brain stimulation. There were no side effects related to the stimulation. Final TRS months after operation was 3 for the proximal and 4 for the distal arm.
一名患有脑干海绵状血管瘤的30岁男性于2008年发生出血并接受了手术。术后6个月，患者出现了新的症状，即左臂震颤，也就是霍姆斯震颤。神经学检查还发现左侧核间性眼肌麻痹、左侧轻度轻瘫、左上肢深腱反射亢进以及躯干共济失调和构音障碍。脑部磁共振成像显示，在右侧被盖和右侧红核的上、下丘水平有一个术后腔隙和胶质增生，并延伸至黑质。他左上肢的法恩-托洛萨-马林震颤评定量表（TRS）（A部分，评分6），近端和远端手臂的评分为11分。在药物治疗无效后，患者接受了右侧苍白球内侧部和丘脑腹中间核深部脑刺激。没有与刺激相关的副作用。术后数月，近端手臂的最终TRS评分为3分，远端手臂为4分。
