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Journal of Korean Neurosurgical Society > Volume 33(6); 2003 > Article
Journal of Korean Neurosurgical Society 2003;33(6): 585-587.
Limb-Shaking Transient Ischemic Attack due to Stenosis of the Middle Cerebral Artery: Case Report.
Ji Ha Kim, Chang Wan Oh, Dae Hee Han, Jae Kyu Roh
1Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea. wanoh@snu.ac.kr
2Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.
ABSTRACT
We present a case of a 51-year-old man with frequent left limb-shaking transient ischemic attacks due to severe stenosis of the right proximal middle cerebral artery(MCA). The involuntary movement was provoked by walking and it was relieved by adopting a squatting posture. Initially, we tried antiepileptic medication, but it did not eliminate the involuntary movement. Cerebral angiography and single photon emission computed tomography demonstrated decreased perfusion and reserve capacity of the right cerebral hemisphere which correspond to stenotic proximal MCA territory. After superficial temporal artery to MCA anastomosis, the decreased reserve capacity was restored and his limb-shaking attack completely disappeared. His history of radiotherapy for craniopharyngioma, in addition to hypercholesterolemia and diabetes mellitus, seems to have contributed to gradual stenosis of right MCA.
Key Words: Limb-shaking TIA; STA-MCA anastomosis; Radiotherapy; MCA stenosis
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