Teaching Video NeuroImage: Reversible Caudate Changes in a Patient With Post-Pump Chorea

A 28-year-old woman with no significant family history presented with a 4-week complaint of involuntary movements after a pulmonary endarterectomy requiring deep hypothermic circulatory arrest (Video 1). Brain MRI revealed bilateral caudate T2 hyperintensity, which resolved after 3 months (Figure). Tetrabenazine initially controlled her generalized chorea and was subsequently withdrawn by 6 months with near-complete resolution of symptoms. Post-pump chorea is rare, often occurring in children after cardiopulmonary surgery and presenting with several distinct imaging findings.1 Risk factors include circulatory arrest and prolonged deep hypothermia. Although the prognosis varies, some patients have a complete resolution of chorea within months.1,2

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