Pathophysiology of parkinsonism due to hydrocephalus
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
Journal of neurology, neurosurgery, and psychiatry
Digital Object Identifier (DOI)
Racette, B A.; Esper, G J.; Antenor, J; Black, K J.; Burkey, A; Moerlein, S M.; Videen, T O.; Kotagal, V; Ojemann, J G.; and Perlmutter, J S., "Pathophysiology of parkinsonism due to hydrocephalus" (2004). Neurology. 1162.