A 70-year-old man with hypertension presents with sudden-onset violent flinging movements of his left arm and leg. Vitals: BP 158/92 mmHg, HR 88, RR 16, temp 37.2°C, SpO2 98%. He remains alert and oriented with intact strength throughout. MRI reveals a small lacunar infarct in the right diencephalon; diffusion-weighted imaging confirms acute ischemia. No sensory deficits are noted. Which of the following structures is most likely involved?
- A)Red nucleus
- B)Subthalamic nucleusGABARITO
- C)Globus pallidus internus
- D)Substantia nigra pars compacta
- E)Caudate nucleus
Explicação
Subthalamic nucleus is correct. Lesions of the subthalamic nucleus remove excitatory input to the globus pallidus internus, reducing inhibitory outflow from the basal ganglia and producing hemiballismus. The movements are wild, flinging, and contralateral to t... Ver explicação completa e trilha adaptativa →