Reverzibilna hemikorea i hemibalizam uzrokovani stenozom unutarnje karotidne arterije - Prikaz slučaja

Autor: Irena Gašparić, Ferdinand Slišurić, Tomislav Stastny, Sandra Gašparić
Jazyk: chorvatština
Rok vydání: 2017
Předmět:
Zdroj: Medica Jadertina
Volume 47
Issue 3-4
ISSN: 1848-817X
0351-0093
Popis: Hemibalizam i hemikorea su nevoljne kretnje koje nastaju oštećenjem subtalamičke jezgre i bazalnih ganglija. Najčešće su posljedica moždanoga udara, metaboličkih poremećaja, tireotoksikoze ili uporabe nekih lijekova. Rijetko je uzrok stenoza karotidne arterije, bez kliničkih i neuroradioloških znakova moždanoga udara. U radu smo prikazali rijedak slučaj bolesnice s prolaznim hemibalizmom i hemikorejom uzrokovanom značajnom stenozom ekstrakranijskog dijela unutranje karotidne arterije. Neuroradiološkim prikazom mozga nije evidentirano akutnih vaskularnih lezija u bazalnim ganglijima. Kao posljedica stenoze unutarnje karotidne arterije razvila se hipoperfuzija njezinog opskrbnog područja i hemodinamske promjene bazalnih ganglija, što je rezultiralo nevoljnim kretnjama tipa hemikoreje i hemibalizma. Na provedeno medikamentozno liječenje nije bilo adekvatnog kliničkog učinka, te se pristupilo operativnom liječenju stenoze. Nakon učinjene karotidne endarterektomije, poboljšala se cereberalna hemodinamika i kliničko stanje bolesnice. Postope-rativno nije više registrirano novih nevoljnih kretnji. Cilj je prikazati rijedak slučaj nevoljnih kretnji uzrokovanih značajnom stenozom unutarnje karotidne arterije, uz hemodinamske promjene u bazalnim ganglijima. Liječenjem karotidne bolesti endarterektomijom postiglo se poboljšanje cerebralne mikrocirkulacije i izlječenje nevoljnih pokreta.
Hemiballismus and hemichorea are involuntary movements occurring due to damage to the subthalamic nucleus and basal ganglia. Most often, they are consequences of strokes, metabolic disorders, thyreotocsicosis or use of certain medicines. It is rarely caused by carotid artery stenosis, without clinical and neuroradiological signs of a stroke. In the present paper, we have demonstrated a rare case of a patient suffering from transient hemiballismus and hemichorea caused by significant stenosis of the extracranial part of the internal carotid artery. A neuroradiological review of the brain did not record any acute vascular lesions in the basal ganglia. As a consequence of internal carotid artery stenosis, hypoperfusion developed within its supply area and basal ganglia hemodynamic changes – resulting in hemichorea-hemiballismus type of involuntary movements. There were no adequate clinical effects in response to a performed medication treatment and a surgical treatment of the stenosis was selected. After carotid endarterectomy completion, cerebral hemodynamics and the clinical condition of the patient improved. New involuntary movements were no longer observed following surgery. The objective is to review a rare case of involuntary movements caused by significant internal carotid artery stenosis and basal ganglia hemodynamic changes.The treatment of the carotid disease using endarterectomy achieved an improvement of cerebral microcirculation and cessation of involuntary movements.
Databáze: OpenAIRE
Externí odkaz: