Parkinsonism secondary to subdural haematoma

Parkinsonism consists of several extrapyramidal signs, characterized by tremor, muscle rigidity, and loss of postural reflexes. The most common cause of parkinsonism is idiopathic Parkinson's disease, whereas the secondary forms include drug exposure, trauma, infection, and chronic subdural haematomas. Four patients with parkinsonism out of 1,289 chronic subdural haematomas were admitted to our hospital between 1985 and 2010. Nineteen patients identified in the literature were also included in this revision. Of the 23 cases reviewed (19 men and 4 women; age at diagnosis ranged between 38 and 83 years; mean, 68.8), the interval between initial symptoms and haematoma diagnosis ranged between 1 week and 1 year (mean interval, 8 weeks). The haematoma was unilateral in 13 cases and bilateral in 10 cases. All chronic subdural haematomas were resolved using different surgical techniques with marked improvement following surgery. Parkinsonism is a rare presentation of chronic subdural haematoma. However, the sudden onset of parkinsonisms requires prompt neuroimaging to rule out this potentially reversible aetiology. The prognosis of chronic subdural haematoma-related parkinsonism is favourable after surgical evacuation.