患者同侧皮质梗死所致偏侧舞蹈症：病例报告。
Hemichorea in a patient with ipsilateral cortical infarction: a case report.
机构信息
Department of Neurology, 905th Hospital of PLA Navy, No 1328 Huashan Road, Changning District, Shanghai, 200052, China.
Department of Neurology, Huashan Hospital, Fudan University, No.12 Wulumuqi Road, Jing'an District, Shanghai, 200040, China.
出版信息
BMC Neurol. 2021 Oct 29;21(1):420. doi: 10.1186/s12883-021-02420-4.
BACKGROUND
Hemichorea is usually caused by contralateral deep structures of brain. It rarely results from acute cortical ischemic stroke and that caused by ipsilateral brain lesions is even rarer.
CASE PRESENTATION
A 64-year-old female presented with acute obtuseness and left-sided hemichorea. She had a history of right frontal lobe surgery and radiotherapy due to brain metastasis from lung cancer 8 years ago. MRI revealed acute left frontal lobe infarction in addition to an old right frontal lobe lesion. 18FDG PET-CT showed hypometabolism in the left frontal lobe and hypermetabolism in the right basal ganglia region and central sulcus. The choreatic movement remitted after antipsychotic treatment.
CONCLUSION
The mechanism of hemichorea after ipsilateral cortical infarction is poorly understood. We assume both previous contralateral brain lesion and recent ipsilateral ischemic stroke contributed to the strange manifestation in this case.
背景
偏侧舞蹈症通常由对侧脑深部结构引起。它很少由急性皮质性脑梗死引起，而由同侧脑部病变引起的则更为罕见。
病例介绍
一名 64 岁女性因急性意识模糊和左侧偏侧舞蹈症就诊。她 8 年前因肺癌脑转移接受了右额叶手术和放疗。MRI 显示除了右侧额叶陈旧病变外，还出现了左侧额叶急性梗死。18FDG PET-CT 显示左侧额叶代谢低下，右侧基底节区和中央沟代谢增高。抗精神病治疗后舞蹈症运动缓解。
结论
对侧皮质梗死后发生偏侧舞蹈症的机制尚不清楚。我们假设之前的对侧脑部病变和最近的同侧缺血性卒中都导致了该病例的这种奇特表现。
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