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Nonketotic Hyperglycemic Hemichorea/Hemiballismus

Smirniotopoulos, M.D. JGSM - MedPix (2010)

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Nonketotic Hyperglycemic Hemichorea/Hemiballismus

History: This previously healthy 50 y.o. woman presents with the acute onset of left sided hemichorea.

Findings: » CT (acute) • abnormal hyper-attenuation in the right basal ganglia (putamen and caudate head) • old left basal ganglia lacunar infarct • bilateral cerebellar wedge lesions » MRI (subacute - 3 days) • T1W hyperintensity in the same region as hyper-attenuation on CT (putamen and caudate head) • T2W hypointensity in basal ganglia - putamen and caudate head

Ddx: • Cerebral infarction • Reperfusion contrast enhancement • Hemorrhagic stroke • Hypertensive hemorrhage • Angioinvasive mycotic hemorrhage

Dxhow: Clinical, autopsy, and pathology

Exam: Spontaneous choreiform movements of the left arm. • BP 220/104 mm Hg • Glu 421 mg/dl • Ketones (-) • Hgb A1C - 17.7% Video of hemichorea(different pt) - http://en.wikipedia.org/wiki/File:Hemichorea_and_dystonia.ogv

No MeSH data available.


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Nonketotic Hyperglycemic Hemichorea/Hemiballismus

Smirniotopoulos, M.D. JGSM - MedPix (2010)

© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX1956&req=5

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Nonketotic Hyperglycemic Hemichorea/Hemiballismus

History: This previously healthy 50 y.o. woman presents with the acute onset of left sided hemichorea.

Findings: » CT (acute) • abnormal hyper-attenuation in the right basal ganglia (putamen and caudate head) • old left basal ganglia lacunar infarct • bilateral cerebellar wedge lesions » MRI (subacute - 3 days) • T1W hyperintensity in the same region as hyper-attenuation on CT (putamen and caudate head) • T2W hypointensity in basal ganglia - putamen and caudate head

Ddx: • Cerebral infarction • Reperfusion contrast enhancement • Hemorrhagic stroke • Hypertensive hemorrhage • Angioinvasive mycotic hemorrhage

Dxhow: Clinical, autopsy, and pathology

Exam: Spontaneous choreiform movements of the left arm. • BP 220/104 mm Hg • Glu 421 mg/dl • Ketones (-) • Hgb A1C - 17.7% Video of hemichorea(different pt) - http://en.wikipedia.org/wiki/File:Hemichorea_and_dystonia.ogv

No MeSH data available.