{"title":"延迟性偏瘫-半偏瘫:重新定义卒中- tia频谱","authors":"Moustafa A. Mansour , Mohamed Abdel-Fattah El-Salamoni , Hamdi Nabawi Mostafa","doi":"10.1016/j.ensci.2025.100589","DOIUrl":null,"url":null,"abstract":"<div><div>Spectacular shrinking deficit (SSD) is an exceptionally rare cerebrovascular phenomenon defined by the rapid and near-complete resolution of severe neurological deficits following major hemispheric ischemia. We present the first documented case of SSD manifesting as hemichorea-hemiballismus syndrome—a striking and clinically distinct presentation that challenges current understanding of stroke sequelae. A 59-year-old diabetic female developed violent, involuntary left-sided movements one week after transient left hemiplegia, which resolved spontaneously. Neuroimaging revealed T1 hyperintensities in the right striatum without contrast enhancement, subtle diffusion abnormalities, and focal right MCA stenosis, while metabolic workup ruled out hyperglycemic chorea. The patient's refractory symptoms responded uniquely to tetrabenazine, further supporting an ischemic rather than metabolic etiology.</div></div>","PeriodicalId":37974,"journal":{"name":"eNeurologicalSci","volume":"41 ","pages":"Article 100589"},"PeriodicalIF":0.0000,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Spectacular shrinking deficit followed by delayed Hemichorea-Hemiballismus: Redefining the stroke-TIA spectrum\",\"authors\":\"Moustafa A. Mansour , Mohamed Abdel-Fattah El-Salamoni , Hamdi Nabawi Mostafa\",\"doi\":\"10.1016/j.ensci.2025.100589\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><div>Spectacular shrinking deficit (SSD) is an exceptionally rare cerebrovascular phenomenon defined by the rapid and near-complete resolution of severe neurological deficits following major hemispheric ischemia. We present the first documented case of SSD manifesting as hemichorea-hemiballismus syndrome—a striking and clinically distinct presentation that challenges current understanding of stroke sequelae. A 59-year-old diabetic female developed violent, involuntary left-sided movements one week after transient left hemiplegia, which resolved spontaneously. Neuroimaging revealed T1 hyperintensities in the right striatum without contrast enhancement, subtle diffusion abnormalities, and focal right MCA stenosis, while metabolic workup ruled out hyperglycemic chorea. The patient's refractory symptoms responded uniquely to tetrabenazine, further supporting an ischemic rather than metabolic etiology.</div></div>\",\"PeriodicalId\":37974,\"journal\":{\"name\":\"eNeurologicalSci\",\"volume\":\"41 \",\"pages\":\"Article 100589\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-10-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"eNeurologicalSci\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2405650225000437\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Neuroscience\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"eNeurologicalSci","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2405650225000437","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Neuroscience","Score":null,"Total":0}
Spectacular shrinking deficit followed by delayed Hemichorea-Hemiballismus: Redefining the stroke-TIA spectrum
Spectacular shrinking deficit (SSD) is an exceptionally rare cerebrovascular phenomenon defined by the rapid and near-complete resolution of severe neurological deficits following major hemispheric ischemia. We present the first documented case of SSD manifesting as hemichorea-hemiballismus syndrome—a striking and clinically distinct presentation that challenges current understanding of stroke sequelae. A 59-year-old diabetic female developed violent, involuntary left-sided movements one week after transient left hemiplegia, which resolved spontaneously. Neuroimaging revealed T1 hyperintensities in the right striatum without contrast enhancement, subtle diffusion abnormalities, and focal right MCA stenosis, while metabolic workup ruled out hyperglycemic chorea. The patient's refractory symptoms responded uniquely to tetrabenazine, further supporting an ischemic rather than metabolic etiology.
期刊介绍:
eNeurologicalSci provides a medium for the prompt publication of original articles in neurology and neuroscience from around the world. eNS places special emphasis on articles that: 1) provide guidance to clinicians around the world (Best Practices, Global Neurology); 2) report cutting-edge science related to neurology (Basic and Translational Sciences); 3) educate readers about relevant and practical clinical outcomes in neurology (Outcomes Research); and 4) summarize or editorialize the current state of the literature (Reviews, Commentaries, and Editorials). eNS accepts most types of manuscripts for consideration including original research papers, short communications, reviews, book reviews, letters to the Editor, opinions and editorials. Topics considered will be from neurology-related fields that are of interest to practicing physicians around the world. Examples include neuromuscular diseases, demyelination, atrophies, dementia, neoplasms, infections, epilepsies, disturbances of consciousness, stroke and cerebral circulation, growth and development, plasticity and intermediary metabolism. The fields covered may include neuroanatomy, neurochemistry, neuroendocrinology, neuroepidemiology, neurogenetics, neuroimmunology, neuroophthalmology, neuropathology, neuropharmacology, neurophysiology, neuropsychology, neuroradiology, neurosurgery, neurooncology, neurotoxicology, restorative neurology, and tropical neurology.