A 70-year-old woman presented with a 3-week history of progressive left hemichorea-hemiballism. Based on elevated serum glucose (384 mg/dL) and HbA1c (13.2%) plus neuroimaging findings (figure, A and B), she was diagnosed with hyperglycemia-induced hemichorea-hemiballism.1 She was treated with insulin and risperidone with near resolution after 4 days. Additional neuroimaging (figure, C and D) revealed a developmental venous anomaly (DVA) adjacent to the affected putamen. The DVA was associated with increased cerebral blood flow and volume2 (figure, E and F). DVAs are typically asymptomatic. However, we propose that altered hemodynamics within the basal ganglia together with this patient's metabolic disturbance resulted …
Disputes & Debates: Rapid online correspondence
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