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Okune S, Hayakawa M, Hino T, Hiramine T, Akimoto T, Sato M, Ito Y, Marushima A, Takada T, Ishikawa E, Tamaoka A, Matsumaru Y. Transient Hemichorea-hemiballism Induced by a Combination of Postprandial Hypotension and Severe Stenosis of the Innominate Artery Concomitant with Left Carotid Occlusion. Intern Med 2024; 63:577-582. [PMID: 37407451 PMCID: PMC10937142 DOI: 10.2169/internalmedicine.0633-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 05/28/2023] [Indexed: 07/07/2023] Open
Abstract
Hemichorea-hemiballism (HCHB) due to transient ischemic attacks (TIAs) is rare. An 83-year-old woman had repeated episodes of right-sided HCHB for 3 months. Magnetic resonance (MR) angiography demonstrated occlusion of the left carotid and middle cerebral arteries and severe stenosis of the innominate artery, and 24-hour ambulatory blood pressure monitoring showed a blood pressure decrease of >20 mmHg after each meal. We speculated that HCHB developed as TIAs due to hemodynamic failure in the left cerebral hemisphere, caused by a combination of severe stenosis of the innominate artery concomitant with occlusion of the left carotid and middle cerebral arteries as well as postprandial hypotension.
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Affiliation(s)
- Sho Okune
- Department of Stroke and Cerebrovascular Diseases, University of Tsukuba Hospital, Japan
- Department of Neurology, Faculty of Medicine, University of Tsukuba, Japan
| | - Mikito Hayakawa
- Department of Stroke and Cerebrovascular Diseases, University of Tsukuba Hospital, Japan
- Division of Stroke Prevention and Treatment, Faculty of Medicine, University of Tsukuba, Japan
| | - Tenyu Hino
- Department of Stroke and Cerebrovascular Diseases, University of Tsukuba Hospital, Japan
| | - Takato Hiramine
- Department of Stroke and Cerebrovascular Diseases, University of Tsukuba Hospital, Japan
| | - Taisuke Akimoto
- Department of Stroke and Cerebrovascular Diseases, University of Tsukuba Hospital, Japan
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Japan
| | - Masayuki Sato
- Department of Stroke and Cerebrovascular Diseases, University of Tsukuba Hospital, Japan
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Japan
| | - Yoshiro Ito
- Department of Stroke and Cerebrovascular Diseases, University of Tsukuba Hospital, Japan
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Japan
| | - Aiki Marushima
- Department of Stroke and Cerebrovascular Diseases, University of Tsukuba Hospital, Japan
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Japan
| | | | - Eiichi Ishikawa
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Japan
| | - Akira Tamaoka
- Department of Neurology, Faculty of Medicine, University of Tsukuba, Japan
| | - Yuji Matsumaru
- Department of Stroke and Cerebrovascular Diseases, University of Tsukuba Hospital, Japan
- Division of Stroke Prevention and Treatment, Faculty of Medicine, University of Tsukuba, Japan
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Japan
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Clinical Characteristics and Prognostic Risk Factors of Parasellar Chondrosarcoma. Brain Sci 2022; 12:brainsci12101353. [PMID: 36291287 PMCID: PMC9599124 DOI: 10.3390/brainsci12101353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 09/30/2022] [Accepted: 10/04/2022] [Indexed: 11/18/2022] Open
Abstract
Background: Parasellar chondrosarcomas are extremely rare. This study describes the characteristics of parasellar chondrosarcoma and analyzes the risk factors and prognosis based on the resection degree. Methods: Fifteen patients with pathologically diagnosed parasellar chondrosarcoma were retrospectively analyzed for the clinical data, surgical methods, and prognosis to identify relationships between the surgical resection degree, tumor recurrence, and imaging characteristics. Results: Twelve patients had eye dysfunction and ptosis. Differentiation from other parasellar tumors by imaging is difficult. The preoperative Karnofsky Performance Scale (KPS) score positively correlated with the tumor resection degree (p = 0.026) and negatively correlated with the maximum tumor diameter (p = 0.001). Tumor recurrence negatively correlated with the resection degree (p = 0.009). The postoperative KPS score positively correlated with the preoperative KPS score (p < 0.001) and tumor resection degree (p = 0.026), and negatively correlated with the maximum tumor diameter (p = 0.016) and age (p = 0.047). An improved KPS score positively correlated with the tumor resection degree (p = 0.039). Patients who underwent total resection of the chondrosarcoma had longer progression-free survival than those who underwent partial resection (p = 0.0322). Conclusion: Parasellar chondrosarcomas are difficult to resect completely. Preoperative KPS score is an important factor for the degree of resection. KPS score, age, maximum tumor diameter, and resection degree may be important prognostic factors.
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Ahn BJ, Kwon KY. Hemiballism after transient hemiparesis on the same side: a red flag of middle cerebral artery disease? Acta Neurol Belg 2022; 123:615-617. [PMID: 35201594 DOI: 10.1007/s13760-022-01901-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 02/17/2022] [Indexed: 11/01/2022]
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