Document Detail


Hemiballism with insular infarction as first manifestation of Takayasu's arteritis in association with chronic hepatitis B.
MedLine Citation:
PMID:  12574956     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Takayasu's arteritis is a chronic inflammatory idiopathic disease involving large arteries like the aorta and its primary branches. Cell-mediated autoimmunity leading to vascular injury has been suspected in its pathogenesis although the antigen inducing the process remains unknown. CASE REPORT: A 50-year-old male patient suffered from acute hemiballism. Neuroimaging showed an infarction of right temporal insular cortex. Neurosonology and MR-Angiography revealed bilateral long-distant subtotal stenosis of the common carotid artery and left-sided occlusion of the subclavian artery. Positive hepatitis B serology with active viral replication was found. In the absence of other vasculitis or inflammation markers, Takayasu's arteritis was diagnosed and steroid therapy was started. CONCLUSIONS: Unilateral insular lesions may lead to transient hemiballistic movements which could be the result of decreased inhibitory output of the insula to basal ganglia. The hepatitis B virus possibly contains a surface antigen inducing a specific cellular immune response leading to Takayasu's arteritis.
Authors:
Thorleif Etgen; Kerstin Winbeck; Bastian Conrad; Dirk Sander
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of neurology     Volume:  250     ISSN:  0340-5354     ISO Abbreviation:  J. Neurol.     Publication Date:  2003 Feb 
Date Detail:
Created Date:  2003-02-07     Completed Date:  2003-04-03     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0423161     Medline TA:  J Neurol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  226-9     Citation Subset:  IM    
Affiliation:
Department of Neurology, Technical University of Munich, Möhlstrasse 28, 81675 München, Germany. etgen@neuro.med.tu-muenchen.de
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MeSH Terms
Descriptor/Qualifier:
Anti-Inflammatory Agents / therapeutic use
Brain Ischemia / pathology
Carotid Stenosis / pathology
Cerebral Infarction / etiology*,  pathology,  ultrasonography
Dyskinesias / etiology*,  ultrasonography
Hepatitis B, Chronic / complications*,  drug therapy,  pathology
Humans
Magnetic Resonance Angiography
Magnetic Resonance Imaging
Male
Middle Aged
Steroids
Subclavian Steal Syndrome / pathology
Takayasu Arteritis / complications*,  drug therapy,  pathology
Ultrasonography, Doppler, Duplex
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents; 0/Steroids

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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