Dopa-responsive parkinsonism secondary to right temporal lobe haemorrahage.
A 46-year-old man developed a symmetrical parkinsonian syndrome 7 weeks after large right temporal intracerebral haemorrhage resulting from a ruptured arteriovenous malformation. His signs included bradykinesia, rigidity, start hesitation, and poor postural reflexes, without a resting tremor. He also had signs of a Parinaud's syndrome. Computed tomography and magnetic resonance imaging of the brain demonstrated changes in the right temporal lobe associated with the haemorrhage but no abnormality of the basal ganglia or midbrain. Levodopa therapy produced a dramatic improvement within a few days of commencement. We postulate that the parkinsonism resulted from midbrain compression secondary to transtentorial herniation. Although parkinsonism is a rare complication of lobar intracerebral haemorrhage, it is important to recognise as it may be potentially treatable.
Ling
Monica J
MJ
Department of Rehabilitation, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
Aggarwal
Arun
A
Morris
John G L
JG
D000978:Antiparkinson Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002543:Cerebral Hemorrhage / Q000150:complications* / Q000175:diagnosis; D004292:Dominance, Cerebral / Q000502:physiology; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000150:complications* / Q000175:diagnosis; D007980:Levodopa / Q000009:adverse effects / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D010302:Parkinson Disease, Secondary / Q000188:drug therapy* / Q000209:etiology; D012422:Rupture, Spontaneous; D013702:Temporal Lobe / Q000098:blood supply / Q000473:pathology
D000978:Antiparkinson Agents; D007980:Levodopa