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Involuntary Movement Complicated with the Postoperative Stage of the Ruptured Aneurysm: A case report Aritoshi SHIRASAKA 1 , Yoshikata SHINOHARA 1 , Takayuki KUWAHARA 1 , Kazuo SUMIYA 1 , Toshiaki NINCHOJI 2 , Kenichi UEMURA 2 1Department of Neurosurgery, Shida General Hospital of Fujieda 2Department of Neurosurgery, Hamamatsu University School of Medicine Keyword: Involuntary movement , Aneurysm , Subarachnoid hemorrhage , Compliction , Athetosis pp.661-664
Published Date 1991/7/10
DOI https://doi.org/10.11477/mf.1436900291
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Abstract

Involuntary movement complicated with the postop-erative stage of the ruptured cerebral aneurysm is ex-tremely rare. And, the pathophysiology of the involun-tary movement has not been established yet. The au-thors report such a case because of its rarity and to make the mechanism of its appearance clear.

The case was a 45-year-old female who was trans-ported to our clinic after the onset of sudden headache. On admission, she had no neurological deficits without severe headache. CT scan revealed subarachnoid hemorrhage, and left carotid angiogram showed an aneurysm at the bifurcation of the left internal carotid artery. On the day of admission, neck clipping for the aneurysm was successfully performed. Postoperative course was uneventful without mild right hemiparesis which diminished until two weeks after operation. Since the 24th day from operation, athetoid involuntary movement occurred to her four toes.123I-IMP SPECT revealed low perfusion from left frontal base to caudate, and CT scan showed atrophy of the left caudate.

Athetoid involuntary movement as postoperative complication of ruptured cerebral aneurysm has not been reported without our case. We suppose it was caused by the ischemic effect of the left caudate clue to the operative retraction or the delayed vasospasm after subarachnoid hemorrhage.


Copyright © 1991, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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