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Acute ischaemic stroke-related choreoathetosis treated with arterial thrombectomy
  1. Ali Muhammad1,
  2. Egidija Bielskute2,
  3. Paul C Guyler3 and
  4. Iris Q Grunwald1
  1. 1 Department of Stroke Medicine, Southend University Hospital NHS Foundation Trust, Essex, UK
  2. 2 Anaesthetics Department, Southend University Hospital NHS Foundation Trust, Westcliff-on-Sea, UK
  3. 3 Department of Stroke Medicine, Southend University Hospital, Southend, UK
  1. Correspondence to Dr Ali Muhammad, ali.muhammad{at}


A rare case of acute choreoathetosis after acute stroke is presented. This 66-years-old, right-handed Caucasian woman presented with weakness of her right arm and right leg with dysarthria, which resolved by the time she arrived in the emergency department. No obvious focal sign apart from the abnormal choreoathetoid movement of the right arm and leg and of the neck was present. Her medical history included atrial fibrillation without anticoagulation. CT head was nil acute (Alberta Stroke Program Early CT Score of 10). CT angiography of the carotids showed a hyperdense M2 segment of the left middle cerebral artery. Intravenous thrombolysis immediately followed by thrombectomy was decided. Using the Penumbra aspiration device (ACE 68) two clots were removed with two aspirations. A small distal clot remained but partial recanalisation (Thrombolysis in Myocardial Infarction/Thrombolysis in Cerebral Infarction 2b) was achieved. 30 seconds after restoring blood flow, the choreoathetoid movements ceased. The patient was brought to intensive care for further monitoring, which was uneventful.

  • neuroimaging
  • stroke
  • movement disorders (other than Parkinsons)

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  • Contributors AM received the patient in Southend University Hospital Accident and Emergency and activated stroke pathway. IQG reviewed the scans and decided and performed thrombectomy for the patient. AM wrote the case report, to which EB and PCG helped and contributed.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.