J Korean Neurosurg Soc.  2003 Jun;33(6):585-587.

Limb-Shaking Transient Ischemic Attack due to Stenosis of the Middle Cerebral Artery: Case Report

• Kim JH
• Oh CW
• Han DH
• Roh JK

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.

Keyword

Limb-shaking TIA; STA-MCA anastomosis; Radiotherapy; MCA stenosis

MeSH Terms

Cerebral Angiography
Cerebrum
Constriction, Pathologic*
Craniopharyngioma
Diabetes Mellitus
Dyskinesias
Humans
Hypercholesterolemia
Ischemic Attack, Transient*
Middle Aged
Middle Cerebral Artery*
Perfusion
Posture
Radiotherapy
Temporal Arteries
Tomography, Emission-Computed, Single-Photon
Walking