Pathophysiology of parkinsonism due to hydrocephalus

Document Type

Article

Abstract

We report a patient with hydrocephalus who developed levodopa responsive parkinsonism and severe bradyphrenia associated with shunt malfunction and revision. Magnetic resonance imaging revealed periaqueductal edema involving medial substantia nigra. [18F]dopa positron emission tomography demonstrated reduced uptake in the caudate and putamen with relative sparing of the posterior putamen. Hydrocephalus associated with shunt malfunction can cause a distinct parkinsonian syndrome with greater dysfunction of projections from the medial substantia nigra to anterior striatum than in idiopathic Parkinson's disease.

Medical Subject Headings

Adult; Antiparkinson Agents (therapeutic use); Brain Mapping; Carbidopa (therapeutic use); Caudate Nucleus (physiopathology); Cerebral Ventricles (physiopathology); Drug Combinations; Equipment Failure; Humans; Hydrocephalus (complications, physiopathology, surgery); Hypokinesia (drug therapy, physiopathology); Levodopa (therapeutic use); Magnetic Resonance Imaging; Male; Neurologic Examination; Parkinsonian Disorders (drug therapy, physiopathology); Positron-Emission Tomography; Postoperative Complications (drug therapy, physiopathology); Putamen (physiopathology); Ventriculoperitoneal Shunt

Publication Date

11-1-2004

Publication Title

Journal of neurology, neurosurgery, and psychiatry

ISSN

0022-3050

Volume

75

Issue

11

First Page

1617

Last Page

9

PubMed ID

15489399

Digital Object Identifier (DOI)

10.1136/jnnp.2003.028449

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