Levodopa-responsive parkinsonism after aneurysmal subarachnoid hemorrhage.
BACKGROUND
Levodopa-responsive Parkinsonism is a rare complication of subarachnoid hemorrhage and no cases have been reported to occur in the absence of hydrocephalus.


METHODS
Case report.


RESULTS
We describe a 42-year-old woman who developed progressive severe Parkinsonism in the second week after aneurysmal subarachnoid hemorrhage. No hydrocephalus was present. Neuroimaging revealed striking abnormalities of the midbrain in the region of the substantia nigra. She was ultimately treated with high dose levodopa/carbidopa with a dramatic response.


CONCLUSIONS
This case suggests that Parkinsonism may occur as a delayed complication of subarachnoid hemorrhage, and that in these patients, a trial of levodopa-carbidopa may be warranted.
Fields
Jeremy D
JD
Neurosciences Critical Care and Interventional Neuroradiology, Oregon Health & Science University, Portland, OR, USA. fieldsje@ohsu.edu
Cetas
Justin S
JS
D000328:Adult; D002230:Carbidopa / Q000627:therapeutic use*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use*; D010300:Parkinson Disease / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D013378:Substantia Nigra / Q000473:pathology
D004338:Drug Combinations; C009265:carbidopa, levodopa drug combination; D007980:Levodopa; D002230:Carbidopa