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- W2078137019 abstract "1016-3190/$ e see front matter Copyright 2012, Bu http://dx.doi.org/10.1016/j.tcmj.2012.10.004 Delayed bilateral internal capsule lesions after chronic subdural hematoma (CSDH) in a patient presenting with progressive quadriparesis and spasticity is extremely rare. A 40-year-old woman had been healthy until 2 years previously when she had a minor head injury after a traffic accident. Initially, she had a mild headache. Three months after the event, she fell and magnetic resonance imaging (MRI) showed a left frontotemporoparietal (FTP) CSDH (Fig. 1). Burr-hole hematoma drainage was performed. She recovered without any neurologic deficit, but progressive spasticity in the four limbs, weakness, and ataxia occurred 1 year, 9 months after the first head injury. Physical examination revealed that the patient had noticeable unsteadiness in gait. There was no family history of any similar neurologic disorder. The neurologic examination did not reveal any cranial nerve deficits. Limb muscle strength was Grade 4 for the right limbs but only Grade 3 for the left limbs. The deep tendon reflexes were 4þ throughout, including the biceps, triceps, brachioradialis, and patellar reflexes. Spasticity in all four limbs was Grade 2 using the modified Ashworth scale. We administered baclofen and performed imaging studies. MRI of the whole spine showed no abnormalities. MRI of the brain after 20 months revealed symmetric hyperintensities within the corticospinal tracts bilaterally on T2-weighted images, which were not evident from the previous MRI study. Focal hyperintensities were also delineated within the internal capsules" @default.
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- W2078137019 date "2014-03-01" @default.
- W2078137019 modified "2023-09-24" @default.
- W2078137019 title "Delayed spasticity in four limbs and ataxia after chronic subdural hematoma surgery" @default.
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- W2078137019 doi "https://doi.org/10.1016/j.tcmj.2012.10.004" @default.
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