Abstract
We report a patient with hydrocephalus who developed levodopa responsive parkinsonism and severe bradyphrenia associated with shunt malfunction and revision. Magnetic resonance imaging revealed periaqueductal edema involving medial substantia nigra. [18F]dopa positron emission tomography demonstrated reduced uptake in the caudate and putamen with relative sparing of the posterior putamen. Hydrocephalus associated with shunt malfunction can cause a distinct parkinsonian syndrome with greater dysfunction of projections from the medial substantia nigra to anterior striatum than in idiopathic Parkinson's disease.
Publication types
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Case Reports
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Research Support, Non-U.S. Gov't
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Research Support, U.S. Gov't, P.H.S.
MeSH terms
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Adult
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Antiparkinson Agents / therapeutic use
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Brain Mapping
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Carbidopa / therapeutic use
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Caudate Nucleus / physiopathology
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Cerebral Ventricles / physiopathology
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Drug Combinations
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Equipment Failure
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Humans
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Hydrocephalus / complications*
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Hydrocephalus / physiopathology
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Hydrocephalus / surgery
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Hypokinesia / drug therapy
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Hypokinesia / physiopathology
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Levodopa / therapeutic use
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Magnetic Resonance Imaging
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Male
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Neurologic Examination
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Parkinsonian Disorders / drug therapy
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Parkinsonian Disorders / physiopathology*
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Positron-Emission Tomography
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Postoperative Complications / drug therapy
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Postoperative Complications / physiopathology*
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Putamen / physiopathology
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Ventriculoperitoneal Shunt*
Substances
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Antiparkinson Agents
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Drug Combinations
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Levodopa
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Carbidopa