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Subarachnoid hemorrhage and extrapyramidal symptoms: a case report
Patrizia Mammi1, Rodolfo Brianti, Laura Galuppo
1Rehabilitation department, Parma Hospital. pmammi@ao.pr.it.
Acta Bio-Medica : Atenei Parmensis
|September 21, 2016
Summary
Subarachnoid hemorrhage can lead to Parkinsonism. This case report shows Levodopa effectively treated Parkinsonian symptoms after an aneurysm rupture and subsequent complications.
Area of Science:
- Neurology
- Neurosurgery
Background:
- Parkinsonism is a known complication of various brain lesions, including subarachnoid hemorrhage, hydrocephalus, slit ventricle, and shunt revision.
- The precise pathogenesis of post-lesional Parkinsonism remains incompletely understood.
Observation:
- A 53-year-old male presented with Parkinsonian symptoms following subarachnoid hemorrhage from an anterior communicating artery aneurysm rupture.
- The patient developed bilateral extrapyramidal symptoms, confirmed by DaTscan showing nigrostriatal dopaminergic pathway impairment.
Findings:
- Levodopa therapy resulted in complete remission of the patient's Parkinsonian symptoms.
- Potential causes for nigrostriatal damage include shear, torsion, and ischemia related to the initial hemorrhage and subsequent interventions like shunt placement/revision.
Implications:
- This case highlights a potential pathway for acquired Parkinsonism following cerebrovascular events and neurosurgical interventions.
- Effective Levodopa treatment suggests dopaminergic deficits are a key mechanism in this type of Parkinsonism.
