Pure Cortical Stroke Causing Hemichorea-Hemiballismus

J Stroke Cerebrovasc Dis. 2019 Oct;28(10):104287. doi: 10.1016/j.jstrokecerebrovasdis.2019.07.003. Epub 2019 Jul 25.

Abstract

Background: Movement disorders including hemichorea-hemiballism as the initial presentation of an acute ischemic stroke are uncommon. Structures outside of the deep subcortical areas such as the subthalamic nucleus or basal ganglia are rarely involved.

Case report: We report a case of a 72-year-old man with vascular risk factors who presented with acute onset right-sided hemichorea-hemiballism. Metabolic-, infectious-, and toxic-related conditions were ruled out, his EEG was without epileptiform changes. An MRI confirmed an acute ischemic stroke in the parieto-occipital region without any subcortical structures involved. Atrial Fibrillation was later discovered during his hospitalization and was treated appropriately.

Conclusions: Although rare, strokes outside of the subthalamic nucleus can result in hemichorea-hemiballism.

Keywords: Stroke—movement disorder—hemichorea—hemiballism.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Atrial Fibrillation / complications*
  • Atrial Fibrillation / diagnosis
  • Cerebral Infarction / diagnostic imaging
  • Cerebral Infarction / etiology*
  • Cerebral Infarction / physiopathology
  • Chorea / diagnosis
  • Chorea / etiology*
  • Chorea / physiopathology
  • Dyskinesias / diagnosis
  • Dyskinesias / etiology*
  • Dyskinesias / physiopathology
  • Humans
  • Male