Hypoxic‐ischemic damage of the basal ganglia case reports and a review of the literature

Abstract

Three cases of movement disorders secondary to hypoxic‐ischemic encephalopathy are reported. Despite similarities among the clinical events, the neurological syndromes produced were dissimilar. Cerebral hypoxiaischemia typically produces lesions of the globus pallidus that may result in an akinetic rigid syndrome. Due to its unique blood supply, vascular insufficiency is found to be a major factor. Lesions in the putamen also occur, and these tend to be associated with dystonia. Recent evidence supports a specific neuronal sensitivity in the striatum, possibly due to afferent excitatory amino acid connections. These two components and changes in the levels of neurotransmitters during hypoxia‐ischemia may interact to produce varied clinical outcomes. These factors must also be considered when planning therapeutic interventions.