Disconnection Syndrome in Acute Hydrocephalus due to Intraventricular Hemorrhage

The right and left hemispheres of the brain play somewhat different roles but help each other perform higher cortical functions. A 43 year-old right-handed woman was admitted due to a intraventricular hemorrhage followed by hydro-cephalus. A brain MRI revealed an intraventricular hemorrhage in the lateral, 3rd, and 4th ventricle and the hemorrhage in the lateral ventricle was compressing the genu of the corpus callosum. When asked to draw the face of a clock, she placed the numbers in reverse order (counter clockwise) when performing the task with her right hand, whereas the same task performed by the left hand was normal. In addition, when she wrote out simultaneously with right and left hands , she wrote Korean words in their mirror image with her left hand . When she wrote Chinese characters, she performed better with her right hand. These findings revealed some aspects of interhemispheric interaction in processing the images of a clock, and the orthographic lexicon of Korean and Chinese characters.

A Case of Hemichorea Ipsilateral to the Basal Ganglia Hemorrhage

Hemichorea is usually caused by lesions in the contralateral subthalamus and basal ganglia. Ipsilateral lesions have rarely been reported to be responsible for the abnormal movement. A 27 year-old woman with well-controlled hyper-thyroidism presented with sudden involuntary movements in the right limbs and a mild headache. The movements were random, irregular, repetitive, and most prominent in the right hand and forearm, but also found in the right leg and face. She experienced no weaknesses in the contralateral limbs. A brain magnetic resonance imaging(MRI) taken after 7 days showed early subacute hematoma in the right basal ganglia. There were no lesions in the left hemisphere. In a cerebral angiography, the bilateral major cerebral vessels were narrowed around the circle of Willis. We critically review previous reports of and explanations for the development of ipsilateral hemichorea.