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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Middle Cerebral Artery Occlusion Presenting as Upper Limb Monochorea
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Middle Cerebral Artery Occlusion Presenting as Upper Limb Monochorea

机译：呈现为上肢Monochorea的中脑动脉闭塞

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Background: Hemichorea is usually caused by a structural lesion in the contralateral basal ganglia or subthalamic nuclei or it develops as a form of a neurologic complication including hyperglycemia. We report a rare case of a patient who developed choreic movement in the right upper extremity associated with a contralateral middle cerebral artery (MCA) occlusion. Methods: A 76-year-old man presented with chorea in the right upper limb, known as monochorea, which occurred after recovery from losing consciousness while standing. He was found to have idiopathic orthostatic hypotension. His diffusion-weighted magnetic resonance imaging did not show signal changes indicative of acute ischemic lesions. A left carotid artery angiogram showed occlusion of the left MCA. I-123-N-isopropyl-4-iodoamphetamine single-photon emission computed tomography of the brain showed marked hypoperfusion in the left MCA territory. His cerebrovascular reserve capacity determined using acetazolamide was relatively decreased in this territory. This decrease in cerebrovascular reserve capacity, however, did not require surgical treatment, such as extracranial-intracranial bypass surgery. Results: The recurrence of chorea was not observed after antiplatelet therapy and instruction on how to cope with orthostatic hypotension. Conclusions: It is considered that transient hemodynamic ischemia in the right basal ganglia-thalamocortical circuits because of the combination of MCA occlusion and hypotension was the underlying cause of the monochorea in this patient. Vascular imaging studies for early identification of occlusion or severe stenosis of cerebral major arteries should be carried out in patients acutely presenting with chorea, even in the absence of other clinical signs.
机译：背景：血清伤通常由对侧基底神经节或亚粒细胞核中的结构病变引起，或者它被发展为包括高血糖血症的神经系统并发症的形式。我们报告了罕见的患者患者在与对侧中脑动脉（MCA）闭塞相关的右上末端开发了疗法运动的患者。方法：76岁男子在右上肢体上呈现舞蹈病，称为单色，在站立时恢复意识后发生。他被发现具有特发性的原因性低血压。他的扩散加权磁共振成像未显示指示急性缺血性病变的信号变化。左颈动脉血管造影显示左侧MCA的闭塞。 I-123-N-异丙基-4-碘邻苯丙胺单光子发射计算的脑部显示出左侧MCA领域的显着低血量灌注。他在本领土中使用乙酰唑胺确定的脑血管储备能力相对较低。然而，这种降低脑血管储备能力不需要外科治疗，例如颅内颅内旁路手术。结果：抗血小板治疗后未观察到曲叶的复发和关于如何应对原疏性低血压的指示。结论：由于MCA闭塞和低血压的组合，右基部神经节血管内容术中的瞬时血流动力学缺血是该患者Monochorea的潜在原因。用于早期鉴定脑主要动脉的早期识别闭塞或严重狭窄的血管成像研究应在患有乔利亚的患者中进行，即使在没有其他临床症状的情况下也是如此。

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