Hemichorea Resulting from Ischemic Stroke in the Ipsilateral Caudate Nucleus

Abstract

Background: Hemichorea may appear with pathologic change in the connections with contralateral subthalamic nucleus (STN) as well as ipsilateral lesion, although such cases are relatively rare. Herein, we presented a patient presenting hemichorea with ipsilateral caudate nucleus infarction and severe stenosis in the contralateral carotid artery. Case Report: An 81-year-old man visited our hospital for involuntary movement of the left hemibody of 5 days duration. Brain magnetic resonance image (MRI) and angiography revealed acute ischemic infarction in the left head of caudate nucleus and severe asymptomatic stenosis in the right carotid bulb. Brain perfusion MRI indicated time delay in the right middle cerebral artery territory. Conclusion: Chronic hypoperfusion of contralateral basal ganglia by stenosis of carotid bulb and disrupted compensation from the opposite site due to acute ischemic stroke on ipsilateral basal ganglia was the possible cause of hemichorea.

Keywords

• Hemichorea
• Caudate nucleus
• Carotid artery stenosis
• Ipsilateral
• Basal ganglia