Chorea accompanied with chronic subdural hematoma: A case report and literature review

Introduction: Chronic subdural hematoma (CSDH) presents hemipalsy, gait disturbance, dysarthria, cognitive disorder, or conscious level down. These hypokinetic movement dysfunctions are brought from the downregulation of the cerebral neural activities, which are caused by the hematoma compression. In contrast, a rare case of CSDH patients shows hyperkinetic movement disorders. Case Report: An 82-year-old woman presented with chorea in the head and extremities, which was dominant in the right hand. The involuntary movement progressed for last three days. Her conscious level was clear and the function of the lower cranial nerves was normal. She had no hemipalsy nor sensory disorders. Brain magnetic resonance image revealed a chronic subdural hematoma in left hemisphere. After the removal of hematoma through surgical irrigation and evacuation, the chorea disappeared immediately. Conclusion: Subdural hematoma compressed cerebral cortex, which disturbed the neural network function. Especially, modulation of the cortico-basal ganglia loop function by subdural hematoma causes to the involuntary movement disorders as chorea. This report describes a rare case of chorea associated with CSDH. Previous case literatures are reviewed and summarized.