Presumed topography of basal ganglion: Derived from TRODAT images in a case of hemorrhagic stroke complicated with asymmetrical cogwheel rigidity

Introduction: Systemic maps of basal ganglion lesion corresponding to clinical symptoms are lacking at present. Only the framework of functional domains in striatum was presumed. We present a case with asymmetrical cogwheel rigidity which is related to the lesion site of the basal ganglion in his functional brain image. Case presentations: A 50-year-old male who suffered from subarachnoid hemorrhage and intracranial hemorrhage presented with upper limbs cogwheel rigidity. The symptom was more severe in the right side than the left side. Dopamine transport images revealed bilateral decreased dopamine transporter binding capacity in bilateral striatum. In left striatum, decreased uptake in dorsal region is more severe than ventral region. Cogwheel rigidity was mildly improved after use of pramipexole. Conclusions: This case report suggests that asymmetrical cogwheel rigidity is linked to the lesion site of the basal ganglion. Topography exists in the striatum and is related to dysfunctional site of parkinsonism.