Putaminal cavernous angioma presenting with hemichorea

Donmez, Berril; Çakmur, Raif; Uysal, Utku; Men, Süleyman

doi:10.1002/mds.20207

Cited by 16 publications

(17 citation statements)

References 9 publications

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“…The clinical picture in all five cases was described as hemichorea. The lesion in another cavernoma case resulting in hemichorea was identified in the putamen (3). The clinical picture in this 65-year old patient was assessed as hemichorea and the patient benefited from 1000 mg sodium valproate treatment (3).…”

Section: Discussionmentioning

confidence: 99%

“…Unilateral chorea is known as hemichorea and is usually associated with vascular causes, including cerebral infarctions, arteriovenous malformations and subdural hematomas (2). Cavernomas rarely cause chorea and there are fairly few cases reported in the literature (3,4,5,6,7,8). Here we discuss a case of intracerebral cavernoma identified as a result of investigations in a case of chorea where the initial clinical picture of hemichorea later transformed to limited chorea of unilateral lower extremity.…”

Section: Introductionmentioning

confidence: 93%

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İntraserebral Kavernoma Bağlı Koreiform Hareket Bozukluğu: Olgu Sunumu

Barut¹,

Demiryürek²,

Türksoy³

2013

tnd

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Sum maryAlthough vascular factors are considered primarily in the etiology of hemichorea among the elderly, chorea related to congenital vascular malformations including cavernous angioma are reported very rarely. We found cavernous angioma to be the cause of persistant, unilateral chorea localized to the right lower extremity in a 83 year-old woman. In this article we would like to highlight the etiology of chorea in patients with late onset movement disorders.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 93%

İntraserebral Kavernoma Bağlı Koreiform Hareket Bozukluğu: Olgu Sunumu

Barut¹,

Demiryürek²,

Türksoy³

2013

tnd

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“…4,6,13 Often grouped with brainstem CMs as deep lesions, 11,13 basal ganglia CMs have their own set of unique presenting signs, 3,5,14,15 accompanying management decisions, and surgical approaches. 4,6 As such, they are more suitable for separate analysis, although their rarity, particularly in children, often precludes doing so.…”

Section: ©Aans 2013mentioning

confidence: 99%

“…3,5,6,14,15 Although CM location has not been demonstrated to be a consistent, significant risk factor for hemorrhage, 7,9,12 Porter et al 11 demonstrated that deep CMs are more likely to be clinically aggressive, probably because of the surrounding eloquent tissue and the resultant increased sensitivity of adjacent brain parenchyma to small changes in lesion size. A recent review reported an annual hemorrhage rate of 2.8%-4.1% for CMs of the basal ganglia; 6 however, differentiating asymp tomatic from symptomatic lesions is crucial because the latter seem to be more aggressive.…”

Section: Presenting Signs and Natural Historymentioning

confidence: 99%

Cavernous malformations of the basal ganglia in children

Gross¹,

Smith²,

Scott³

2013

PED

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Object Cavernous malformations (CMs) of the basal ganglia are relatively rare lesions that can lead to considerable neurological impairment because of their eloquent location. The authors reviewed the clinical course and surgical outcome of a series of children with basal ganglia CMs. Methods The authors retrospectively reviewed the operative experience of the senior author (R.M.S.) and the 1997–2011 database of Boston Children's Hospital for children with CM of the basal ganglia (which includes CM of the caudate and/or lentiform nucleus and excludes CM of the thalamus). They evaluated baseline demographics, presenting signs, operative outcomes, and condition at long-term follow-up visits and compared these characteristics among patients who underwent surgery and those who were observed. Results Of 180 children with a diagnosis of CM, 11 (6%) had CM of the basal ganglia. The mean age at diagnosis was 9.3 years, and the male/female ratio was 1.8:1. Presenting signs were as follows: hemorrhage (8 children), incidental lesions (2), and seizures (1); 2 children had choreiform movement disorders. Treatment was observation or surgery. Observation was chosen for 5 children either because the lesions were asymptomatic (2 children) or because the risk for neurological dysfunction after attempted excision was believed to be high (3 children). These 5 children were observed over a combined total of 30.4 patient-years; none experienced neurological deterioration or symptomatic hemorrhage from their lesions. The other 6 children underwent microsurgical resection of the lesion because they were symptomatic from hemorrhage or increasing mass effect. All 6 of these children had hemorrhagic lesions, of which the smallest dimension was at least 1.5 cm. Of these 6 lesions, 5 were excised completely, and over a combined total of 46 patient-years of follow-up, no rebleeding or late neurological deterioration after surgery was reported. Conclusions In this patient population, the natural history of small and asymptomatic CMs of the basal ganglia was benign. The children with large (> 1.5 cm) symptomatic lesions underwent excision; neurological impairment was apparently minimal, and no hemorrhage or neurological deterioration occurred later.

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“…Late-onset cases are secondary and vascular causes are usually prominent (2,3,5,6,7,8,9,10,11,12,13,14). Infarct, hemorrhage, cavernoma, and arteriovenous malformation (AVM) are among the possible vascular causes (2,3,5,6,7,8,9,10,11,12,13,14). Metabolic disturbances including hyperglycemia, particularly nonketotic hyperglycemia may be associated with many neurologic disorders (4).…”

Section: Introductionmentioning

confidence: 99%

Hemichorea and Hemiballismus Associated with Cerebral Vascular Malformation Induced by Hyperglycemia: Case Report

Selçuk¹,

Sorgun²,

Akpınar³

2016

tnd

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Hemichorea, hemiballismus, and hyperglycemia associated with vascular malformation is rare. We report a patient who presented with involuntary movements in the left-side with concurrent hyperglycemia. The patient had type 2 diabetes mellitus (DM) and a venous angioma in the basal ganglia on the cranial magnetic resonance imaging (MRI). A woman aged 49 years presented with flinging and throwing movements of the left upper and lower limb, which she had had for one month. Her neurologic examination confirmed involuntary, irregular, wide amplitude movements of the left limbs consistent with left hemiballismus. She had hypertension and type 2 DM. Her glucose level was 400 mg/dL. Cranial MRI showed a cavernoma in the right subependymal area of the lateral ventricle and a venous angioma in the right nucleus lentiformis, which was confirmed on digital subtraction angiography. Hemiballismus improved after blood glucose level had been regulated in the follow-up period. Especially in the elderly secondary causes should be investigated in patients with acute or subacute onset of choreaballismus. We think that our patient's clinical presentation was induced by unregulated DM. Venous angioma with chorea-ballismus is rarely stated in literature and we presume the mass effect of venous angioma could be responsible of our clinical findings. Keywords: Chorea, ballismus, vascular malformation, hyperglycemiaVasküler malformasyona bağlı hemiballizm, hemikore ve hiperglisemi birlikteliği olgusuna az rastlanmaktadır. Biz burada başlangıç kliniği sol taraflı istemsiz hareketler olan, yapılan tetkiklerde hiperglisemi saptanan, iyi regüle edilememiş tip 2 diabetes mellitus (DM) özgeçmişi olan ve kranyal manyetik rezonans görüntülemede (MRG) bazal ganglionlar düzeyinde venöz anjiom tespit edilen bir olguyu sunuyoruz. Kırk dokuz yaşındaki kadın hasta, yaklaşık bir aydır sol kol ve sol bacakta, istemsiz, atma şeklindeki hareket şikayeti ile başvurdu. Özgeçmişinde hipertansiyon ve tip 2 DM öyküsü vardı. Hastanın muayenesinde sol taraflı, kalça ve omuzdan başlayan, şiddetli, atma şeklinde hemiballizm görüldü. Hastanın bakılan tetkiklerinde kan şekeri 400 mg/dL olarak ölçüldü. Kranyal MRG'sinde sağ nükleus lentiformis düzeyinde venöz anjiyom ve sağ lateral ventrikül korpus lateralinde, subependimal yerleşimli, vasküler malformasyonu düşündüren lezyon tespit edildi ve ardından dijital dört damar serebral anjiyografisinde gösterildi. Takibinde kan şekeri regülasyonu sağlanan hastanın hemiballizminde tama yakın klinik düzelme oldu. Özellikle ileri yaşlı olgularda, akut veya subakut başlangıçlı kore-ballizm, özellikle sekonder nedenleri akla getirmelidir. Vasküler malformasyona bağlı hemiballizm, hemikore ve hiperglisemi birlikteliği olgusuna az rastlanmaktadır. Sunulan olguda iyi regüle edilememiş DM hastamızın kliniğinin belirmesinde kolaylaştırıcı etken olduğunu ve yine literatürde az rastlanan venöz anjiyom ve kore-ballizm birlikteliğinde, venöz anomalinin özellikle kitle etkisinin klinikten sorumlu olabileceğini düşünüyoruz.

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Putaminal cavernous angioma presenting with hemichorea

Abstract: We report on a 63-year-old man presenting with hemichorea on his right side. Magnetic resonance imaging revealed a left putaminal cavernoma. To our knowledge this is the first report of such a case caused by contralateral putaminal cavernous angioma.

Cited by 16 publications

References 9 publications

İntraserebral Kavernoma Bağlı Koreiform Hareket Bozukluğu: Olgu Sunumu

İntraserebral Kavernoma Bağlı Koreiform Hareket Bozukluğu: Olgu Sunumu

Cavernous malformations of the basal ganglia in children

Hemichorea and Hemiballismus Associated with Cerebral Vascular Malformation Induced by Hyperglycemia: Case Report

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