Acute Ischemic Stroke Presenting as Hemiparkinsonism: A Case Report

Area of Science:

• Neurology
• Neuroscience
• Vascular Neurology

Background:

• Parkinsonism, often linked to Parkinson disease (PD), has diverse etiologies, including vascular parkinsonism (VP).
• VP presents a diagnostic challenge, especially with acute onset following cerebrovascular events.

Observation:

• A 54-year-old male with prior cerebrovascular disease exhibited acute behavioral changes and parkinsonian symptoms post-stroke.
• Clinical presentation included agitation, mutism, rigidity, and immobility.
• Brain imaging confirmed acute and old infarcts in critical areas, supporting VP diagnosis.

Findings:

• The patient was diagnosed with acute vascular parkinsonism following a stroke.
• Treatment with anticoagulation and levodopa/carbidopa yielded minimal improvement over six months.

Implications:

• This case emphasizes considering VP in patients with acute parkinsonian symptoms and cerebrovascular disease history.
• Prompt evaluation and management of vascular risk factors are vital for optimizing outcomes in VP.
• A multidisciplinary approach is recommended for VP management due to limited response to standard PD medications.