Parkinsonism and midbrain dysfunction after shunt placement for obstructive hydrocephalus.
We report a patient in whom placement of a ventriculoperitoneal shunt for obstructive hydrocephalus secondary to non-neoplastic aqueductal stenosis was complicated by progressive parkinsonism and midbrain dysfunction. These sequelae were refractory to treatment, including shunt revision and levodopa therapy. These findings contradict the opinion from the literature that this type of parkinsonism is a reversible condition and levodopa therapy is effective for managing the symptoms. We discuss the pathophysiological mechanism of this complication.
Yomo
Shoji
S
Department of Neurosurgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan.
Hongo
Kazuhiro
K
Kuroyanagi
Takayuki
T
Kobayashi
Shigeaki
S
D006801:Humans; D006849:Hydrocephalus / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008636:Mesencephalon / Q000473:pathology*; D008875:Middle Aged; D010300:Parkinson Disease / Q000209:etiology*; D013997:Time Factors; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*