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[慢性硬膜下血肿所致舞蹈症]

[Chorea due to chronic subdural hematoma].

作者信息

Shiraishi Tomotaka, Sengoku Renpei, Takanashi Shigehiko, Shibukawa Mari, Kanemaru Kazutomi, Murayama Shigeo

机构信息

Department of Neurology, Tokyo Metropolitan Geriatric Hospital and Institution of Gerontology.

Department of Neurosurgery, Tokyo Metropolitan Geriatric Hospital and Institution of Gerontology.

出版信息

Rinsho Shinkeigaku. 2018 Jun 27;58(6):399-402. doi: 10.5692/clinicalneurol.cn-001102. Epub 2018 Jun 1.

Abstract

An 86-year-old woman presented with generalized chorea in the face and extremities, which gradually progressed for two weeks. Cranial CT revealed a chronic subdural hematoma (CSDH) that covered the left parietal lobe. Discontinuation of amantadine did not improve the chorea. The hematoma was evacuated and the chorea completely subsided in a week. The pathogenesis leading to chorea in CSDH remains unclear. A unilateral hematoma presenting with generalized chorea similar to the present patient and two others with unilateral CSDH causing ipsilateral hemichorea have been reported. The rarity of these movement disorders due to CSDH indicates that these patients had a preclinical dysfunction within neuronal networks interconnecting basal ganglia the cerebral cortex. Our findings confirmed that CSDH could cause chorea, and further neuroimaging to evaluate cerebrovascular disease, taking a detailed family history and obtaining information about current medications might reveal factors likely to precipitate the development of chorea.

摘要

一名86岁女性出现面部和四肢的全身性舞蹈症,持续两周并逐渐进展。头颅CT显示左侧顶叶有慢性硬膜下血肿(CSDH)。停用金刚烷胺后舞蹈症并未改善。血肿清除后,舞蹈症在一周内完全消退。CSDH导致舞蹈症的发病机制尚不清楚。已有报道称,与本患者类似的单侧血肿出现全身性舞蹈症,另外还有两例单侧CSDH导致同侧偏侧舞蹈症。这些由CSDH引起的运动障碍罕见,表明这些患者在连接基底神经节和大脑皮层的神经网络中存在临床前功能障碍。我们的研究结果证实CSDH可导致舞蹈症,进一步的神经影像学检查以评估脑血管疾病、详细询问家族史并获取当前用药信息,可能会揭示引发舞蹈症发展的因素。

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