A Case of Parkinsonism Associated with Secondary Hydrocephalus following Aneurysmal Subarachnoid Hemorrhage

Abstract

A case of parkinsonism caused by hydrocephalus after aneurysmal subarachnoid hemorrhage is reported. A 42-year-old man was admitted with typical symptoms of hydrocephalus, including deteriorated mental status, poor oral intake, gait disturbance and urinary incontinence. He had a past history of aneurysmal subarachnoid hemorrhage clipped one month before. Computed tomographic (CT) scan of the brain revealed dilatation of ventricles with periventricular low densities. He underwent a shunt operation and the symptoms of hydrocephalus were dramatically improved. However, new symptoms just like cogwheel rigidity, masked face, dysarthria and sialorrhea were developed. Levodopa was administrated and the patient showed marked improvement in above symptoms and discharged with independent daily activities. We report this rare clinical presentation and successful management with dopaminergic agent in parkinsonism induced by hydrocephalus after aneurysmal subarachnoid hemorrhage.