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KMID : 1197720130060010013
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대한파킨슨병 및 이상운동질환 학회지
2013 Volume.6 No. 1 p.13 ~ p.16
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A Case of Isolated Middle Cerebral Artery Stenosis with Hemichorea and Moyamoya Pattern Collateralization
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Chung Seok-Jong
Lee Hyung-Seok
Yoo Han-Soo
Kim Kyung-Min
Lee Ki-Jeong
Kim Jong-Soo
Lee Jae-Wook
Kim Jong-Hun
Cho Jeong-Hee
Kim Gyu-Sik
Lee Jun-Hong
Choi Sun-Ah
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Abstract
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Isolated middle cerebral artery (MCA) stenosis in young patients with no other medical condition may be a unique pathologic entity with a benign long-term course. Generally, moyamoya disease shows a progression of stenosis from internal cerebral artery (ICA) to other intracranial vessel. A 26-year-old woman was admitted for choreic movements of the right arm and leg. Brain magnetic resonance imaging showed no stroke. Conventional angiography revealed 48% stenosis of the left M1 without ICA stenosis. Single photon emission computed tomography revealed perfusion asymmetry after acetazolamide injection, suggesting decreased uptake in the left basal ganglia and the cerebral cortex. Her hemichorea was mildly decreased with risperidone. One year later, follow-up angiography showed complete occlusion of the left M1 with neovascularization suggestive of moyamoya disease. The patient underwent bypass surgery and her hemichorea disappeared. This may be an atypical presentation of moyamoya disease. The bypass surgery was an effective measure for restoring the vascular insufficiency and, resultantly, controlling her hemichorea.
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KEYWORD
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Middle cerebral artery stenosis, Hemichorea, Moyamoya
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Listed journal information
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