215. Chorea Secondary to Subdural Hematoma

Article type: Letter to the Editor
Article title: Chorea Secondary to Subdural Hematoma

Journal: Neurology India
Year: 2026
Authors: Jamir Pitton Rissardo and Ana Leticia Fornari Caprara

ABSTRACT
Chorea is a rare manifestation of subdural hematoma (SDH). We report an 83-year-old man who developed progressive right-sided choreiform movements two weeks after the onset of symptoms and one month following head trauma. Neuroimaging demonstrated bilateral subacute SDHs, more prominent on the left side, with mild midline shift. The patient underwent embolization of the left middle meningeal artery, and his chorea gradually improved over six months. To better characterize this unusual presentation, a literature review identified 15 previously reported cases, yielding a total of 16 cases including our patient. The mean age was 68.1 years, with a slight female predominance. Although most patients had unilateral SDH, chorea was more commonly bilateral. Surgical hematoma evacuation was the primary treatment in nearly all reported cases and was generally associated with rapid and complete recovery. In contrast, our patient experienced slower improvement following middle meningeal artery embolization. These findings highlight SDH as an important and potentially reversible cause of chorea, particularly in elderly individuals with recent head trauma, and suggest that direct hematoma evacuation may provide faster symptomatic recovery than embolization alone.
Keywords: chorea, subdural hematoma, movement disorder.

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DOI

Citation
Rissardo JP, Fornari Caprara AL. Chorea secondary to subdural hematoma. Neurol India 2026;74:718-9. doi: 10.4103/neurol-india.Neurol-India-D-25-00663.
Figure 1. Neuroimaging showing chronic subdural hematoma. Cranial computed tomography scans with axial (a) and coronal (b) images. Brain MRI fluid‑attenuated inversion recovery sequence showing chronic subdural hematoma bilaterally (c and d).
Figure 2. Neuroimaging showing resolution of the subdural hematoma. Cranial computed tomography scans with axial (a) and coronal (b) images. Brain MRI fluid‑attenuated inversion recovery (c) and axial T2‑weighted with fat saturation (d) sequences showing chronic subdural hematoma resolution.