1/4. Cerebral arteriovenous malformations and movement disorders.A series of six patients with movement disorders associated with cerebral arteriovenous malformations (AVM) is reported. The AVMs were classified according to the Spetzler-Martin classification as grade V (one patient), grade IV (four patients), and as grade III (one patient). One patient had action-induced hemidystonia caused by a contralateral frontoparietal AVM which compressed the putamen and was supplied partially by enlarged lenticulostriate arteries. Two patients presented with unilateral cortical tremor associated with contralateral high-frontal cortical/subcortical AVMs sparing the basal ganglia. Another patient developed hemidystonia and hemichorea-hemiballism after bleeding of a contralateral temporooccipital AVM and subsequent ischemia. Two patients had focal dystonia after thalamic and basal ganglia hemorrhage from AVMs. Five patients were operated on. The movement disorder was abolished in one patient postoperatively. Different mechanisms were identified that are relevant for the development of AVM-related movement disorders: mass effect, diaschisis, local parenchymal altered cerebral blood flow, and hemorrhagic or ischemic structural lesions.- - - - - - - - - - ranking = 1keywords = putamen (Clic here for more details about this article) |
2/4. Aggravation of poststroke sensory symptoms after a second stroke on the opposite side.The role of the ipsilateral hemisphere in sensory functions remains unknown. The author describes 5 patients who presented with hemisensory symptoms due to unilateral strokes occurring in the left putamen, left thalamus, right putamen, right lateral medulla and left thalamic-internal capsular area, respectively. Sensory symptoms had gradually improved or remained stable after the initial events. However, when another stroke occurred on the contralateral thalamic-occipital, frontoparietal, lateral medulla, temporoparietal and pontine areas, respectively, previous sensory symptoms significantly worsened and became painful. These observations suggest that ipsilateral sensory pathways play a role in the modulation of sensory functions.- - - - - - - - - - ranking = 2keywords = putamen (Clic here for more details about this article) |
3/4. Neuropsychological deficits in a child with a left penetrating brain injury.This case study reports neuropsychological and structural magnetic resonance (MRI) studies of a 10-year-old girl with a left hemisphere lesion, caused by an underwater fishing harpoon penetrating her head when she was 6 years old. The patient showed a marked deficit in the acquisition of reading, writing and arithmetic, as well as an attentional deficit. Magnetic resonance images revealed left cortical lesions in the orbital region and the gyrus angularis, as well as in the caudate and putamen nuclei and longitudinal inferior fascicle. Neuropsychological assessment showed frontal and parietal lobe dysfunctions consistent with the lesional data. The structural data explain the neuropsychological impairment and suggest that, although the left lesion was early and relatively small, plasticity was incomplete.- - - - - - - - - - ranking = 1keywords = putamen (Clic here for more details about this article) |
4/4. High uptake on 11C-methionine positron emission tomographic scan of basal ganglia germinoma with cerebral hemiatrophy.We herein describe a 12-year-old male patient with a germinoma of the basal ganglia who presented with progressive hemiparesis. MR imaging showed ipsilateral cerebral hemiatrophy predominantly in the left basal ganglia, whereas no mass or enhancement was depicted. Single photon emission CT revealed no significant uptake of thallium, whereas (11)C-methionine positron emission tomography showed clearly discernible uptake in the left putamen. Stereotactic biopsy, referencing the results of (11)C-methionine positron emission tomography, was performed, allowing histologic verification of germinoma to be established. (11)C-methionine positron emission tomography was the only technique that indicated the precise localization of the tumor in our patient and enabled biopsy-based final diagnosis of the basal ganglia germinoma without any overt mass formation.- - - - - - - - - - ranking = 1keywords = putamen (Clic here for more details about this article) |