Age: 74
Sex: Male
Indication: Right-sided jerking movements
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Case #21
Findings
- T1 hyperintensity in the left putamen
- No evidence of acute infarct, mass effect, or hydrocephalus
- Scattered T2/FLAIR hyperintensities in the bilateral subcortical and periventricular white matter
- Bilateral basal ganglia calcifications
- Small mucous retention cysts in the right maxillary sinus
- 15 mm T2 hyperintense structure in the left parapharyngeal space
Diagnosis
- Nonketotic hyperglycemic hemichorea-hemiballism
Sample Report
T1 hyperintensity in the left putamen, which given clinically reported contralateral jerking movements is favored to represent nonketotic hyperglycemic hemichorea-hemiballism. Other toxic/metabolic disorders associated with T1 hyperdensity in the basal ganglia are considered unlikely given profound asymmetry.
No evidence of acute infarct, mass effect, or hydrocephalus.
Scattered T2/FLAIR hyperintensities in the bilateral subcortical and periventricular white matter, which though nonspecific likely relate to chronic small vessel disease.
15 mm T2 hyperintense structure in the left parapharyngeal space which may represent a cyst, nerve sheath tumor, or salivary gland neoplasm. Recommend ENT referral for further evaluation.
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