Acute Supratentorial Ischemic Stroke with Ipsilateral Hemiparesis: Pathomechanism and Management Challenges

Patra, Devi P; Narayan, Vinayak; Savardekar, Amey; Dossani, Rimal H; Cajavilca, Christian; Javalkar, Vijaykumar; Gonzalez‐Toledo, Eduardo; Cuellar‐Saenz, Hugo

doi:10.1016/j.wneu.2018.07.172

Cited by 3 publications

(2 citation statements)

References 17 publications

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“…The picture was drawn by Mr. Wende Zhang lobe infarction, disinhibition of left primary motor cortex gave rise to left-sided hemichorea through left uncrossed CST. Other possible mechanisms include lesions that affected the secondary motor area which bilaterally innervate the face and limbs [12], cortical reorganization within the motor areas of the unaffected hemisphere [13] or involvement of ipsilateral fibers with double decussation [12].…”

Section: Discussionmentioning

confidence: 99%

Hemichorea in a patient with ipsilateral cortical infarction: a case report

Wei

Zhang

2021

BMC Neurol

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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.

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Section: Discussionmentioning

confidence: 99%

Hemichorea in a patient with ipsilateral cortical infarction: a case report

Wei

Zhang

2021

BMC Neurol

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“…Subtype IIa designates an injury specifically to the uncrossed corticospinal tract, occurring in individuals with both active crossed and uncrossed tracts, that emerges secondarily to a previous injury of the crossed tract [ 14 ]. Patra et al revised these pathomecanisms and added two more: the involvement of ipsilateral fibers with double decussation, and the Involvement of supplemental motor areas [ [15] , [16] ].…”

Section: Discussionmentioning

confidence: 99%