皮质半偏瘫:半偏瘫伴顶叶梗死1例

P. Shrestha, Janak Adhikari, D. Poudel, R. Pathak, P. Karmacharya
{"title":"皮质半偏瘫:半偏瘫伴顶叶梗死1例","authors":"P. Shrestha, Janak Adhikari, D. Poudel, R. Pathak, P. Karmacharya","doi":"10.4103/1947-2714.172850","DOIUrl":null,"url":null,"abstract":"Context: Hemiballismus is characterized by involuntary, irregular, large amplitude, and violent flinging movements of limbs. Stroke (middle and posterior cerebral artery) remains the most common etiology with 2/3 being lacunar. Lesions outside the substantia niagra (STN) can cause hemiballism, and only a minority by STN lesions, unlike the classical belief. Compared to those arising from STN, cortical hemiballismus is usually less severe with a good prognosis. Case Report: A 61-year-old man presented with sudden onset involuntary flinging movements of his right upper extremity accompanied by numbness and tingling. Past medical history was significant for stroke 2 years back with no residual deficits. Vitals signs were blood pressure of 165/84 mm Hg, and heart rate - 82 beats/min. Irregular, arrhythmic, jerky flinging movement, and decreased sensation to light touch in right upper extremity was noted. Magnetic resonance imaging of the brain revealed acute posterior left parietal lobe infarction. He was treated with aspirin and atorvastatin. Thrombolytic therapy was offered but declined. The movements resolved spontaneously over the next 2 days. No further episodes occurred at 3-month follow-up. Conclusion: Lesions affecting various areas outside the STN can cause hemiballism and usually carries a good prognosis with spontaneous resolution. Acute thrombolytic therapy may be considered on an individual basis. Treatment with antipsychotics can be useful for severe and recurring symptoms.","PeriodicalId":19703,"journal":{"name":"North American Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"7","resultStr":"{\"title\":\"Cortical Hemiballism: A Case of Hemiballismus Associated with Parietal Lobe Infarct\",\"authors\":\"P. Shrestha, Janak Adhikari, D. Poudel, R. Pathak, P. Karmacharya\",\"doi\":\"10.4103/1947-2714.172850\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Context: Hemiballismus is characterized by involuntary, irregular, large amplitude, and violent flinging movements of limbs. Stroke (middle and posterior cerebral artery) remains the most common etiology with 2/3 being lacunar. Lesions outside the substantia niagra (STN) can cause hemiballism, and only a minority by STN lesions, unlike the classical belief. Compared to those arising from STN, cortical hemiballismus is usually less severe with a good prognosis. Case Report: A 61-year-old man presented with sudden onset involuntary flinging movements of his right upper extremity accompanied by numbness and tingling. Past medical history was significant for stroke 2 years back with no residual deficits. Vitals signs were blood pressure of 165/84 mm Hg, and heart rate - 82 beats/min. Irregular, arrhythmic, jerky flinging movement, and decreased sensation to light touch in right upper extremity was noted. Magnetic resonance imaging of the brain revealed acute posterior left parietal lobe infarction. He was treated with aspirin and atorvastatin. Thrombolytic therapy was offered but declined. The movements resolved spontaneously over the next 2 days. No further episodes occurred at 3-month follow-up. Conclusion: Lesions affecting various areas outside the STN can cause hemiballism and usually carries a good prognosis with spontaneous resolution. Acute thrombolytic therapy may be considered on an individual basis. Treatment with antipsychotics can be useful for severe and recurring symptoms.\",\"PeriodicalId\":19703,\"journal\":{\"name\":\"North American Journal of Medical Sciences\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2015-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"7\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"North American Journal of Medical Sciences\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4103/1947-2714.172850\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"North American Journal of Medical Sciences","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/1947-2714.172850","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 7

摘要

背景:半偏瘫的特点是肢体不自主的、不规则的、大幅度的、剧烈的投掷运动。脑卒中(大脑中、后动脉)仍是最常见的病因,其中2/3为腔隙性卒中。烟灰质(STN)外的病变可引起偏瘫,并且只有少数由STN病变引起,这与传统的观点不同。与STN引起的偏瘫相比,皮质偏瘫通常不那么严重,预后良好。病例报告:一名61岁男性,表现为右上肢突然发作不自主甩动,伴有麻木和刺痛。既往病史对2年前卒中有显著影响,无残留缺陷。生命体征:血压165/84 mm Hg,心率- 82次/分。右上肢有不规则、不律动、剧烈的抛掷运动,轻触感觉减弱。脑磁共振成像显示急性左后顶叶梗死。他接受了阿司匹林和阿托伐他汀治疗。提供了溶栓治疗,但被拒绝。在接下来的2天内,这些运动自然消退。随访3个月无进一步发作。结论:累及STN外不同部位的病变可引起半偏瘫,预后良好,可自行消退。急性溶栓治疗可根据个人情况考虑。抗精神病药物治疗对严重和反复出现的症状是有用的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cortical Hemiballism: A Case of Hemiballismus Associated with Parietal Lobe Infarct
Context: Hemiballismus is characterized by involuntary, irregular, large amplitude, and violent flinging movements of limbs. Stroke (middle and posterior cerebral artery) remains the most common etiology with 2/3 being lacunar. Lesions outside the substantia niagra (STN) can cause hemiballism, and only a minority by STN lesions, unlike the classical belief. Compared to those arising from STN, cortical hemiballismus is usually less severe with a good prognosis. Case Report: A 61-year-old man presented with sudden onset involuntary flinging movements of his right upper extremity accompanied by numbness and tingling. Past medical history was significant for stroke 2 years back with no residual deficits. Vitals signs were blood pressure of 165/84 mm Hg, and heart rate - 82 beats/min. Irregular, arrhythmic, jerky flinging movement, and decreased sensation to light touch in right upper extremity was noted. Magnetic resonance imaging of the brain revealed acute posterior left parietal lobe infarction. He was treated with aspirin and atorvastatin. Thrombolytic therapy was offered but declined. The movements resolved spontaneously over the next 2 days. No further episodes occurred at 3-month follow-up. Conclusion: Lesions affecting various areas outside the STN can cause hemiballism and usually carries a good prognosis with spontaneous resolution. Acute thrombolytic therapy may be considered on an individual basis. Treatment with antipsychotics can be useful for severe and recurring symptoms.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信