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A 51-year-old man presented with a 1-year history of gait imbalance and difficulties in the execution of fine movements. On examination, he had hypomimia, bilateral and symmetrical bradykinesia and rigidity (unified Parkinson’s disease rating scale (UPDRS) =17). He had no tremor, impairment of eye movement and cerebellar or pyramidal signs.
MR scan of brain found a giant inter-hemispheric arachnoid cyst, exerting a moderate mass effect on the basal ganglia bilaterally (figure …
VL and GAB contributed equally.
Contributors VL and GAB had the idea and wrote the article. FC, GC and ML contributed to the clinical management of the case.
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Not commissioned. Externally peer reviewed. This paper was reviewed by David Burn, Newcastle-upon-Tyne, UK.