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Japanese

MOTOR WEAKNESS IN THE LATERAL TYPE OF HYPERTENSIVE INTRACEREBRAL HEMORRHAGE : ON THE MECHANISM OF THE DISSOCIATION OF MOTOR WEAKNESS BETWEEN ARM AND LEG Tetsuo Yokoyama 1 , Tomomi Koba 1 , Mitsuo Kaneko 1 1Department of Neurosurgery, Hamamatsu Medical Center pp.55-59
Published Date 1978/1/1
DOI https://doi.org/10.11477/mf.1406204184
  • Abstract
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It is well known since long ago that the motor weakness in the hypertensive intracerebral hemor-rhage is often severer in the arm than in the leg, but its mechanism has not yet been clarified.

We reviewed postoperative Pantopaque radio-grams of the hematoma cavity in 17 cases of the lateral type of hypertensive intracerebral hemor-rhage and discussed on the correlation between the location of the hematoma and the pyramidal tract.

The results were as follows; 1) In patients who showed severe motor weakness both in upper and lower extremities (7 cases), the pyramidal tract was almost completely transsected in the level of the internal capsule or in its upper level of the corona radiata. In these cases, the recovery of motor weakness was very poor, but they could often walk without bending knee. 2) In patients who showed better functional recovery in lower extremity than in upper extremity (5 cases), the hematoma was mostly localized in the putamen and the external capsule and the pyramidal tract was partially destructed in the outer margin of the corona radiata in which portion the fiber to the upper extremity is supposed to descend. 3) In patients who showed good functional recovery in arm and leg, the hematoma was located in the putamen and the external capsule and they were not extended to the pyramidal tract.

As a conclusion, it is most probable that the dis-sociation of the motor weakness between arm and leg is mainly derived from the partial destruction of the pyramidal tract in the level of the corona radiata.


Copyright © 1978, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 2185-405X 印刷版ISSN 0006-8969 医学書院

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