Parkinsonism after Shunting for Hydrocephalus Secondary to Aqueductal Stenosis with Chiari Malformation
نویسنده
چکیده
Parkinsonism has been well-documented in patients with communicating hydrocephalus, but it is an uncommon complication of shunting for obstructive hydrocephalus secondary to aqueductal stenosis. Although a number of hypotheses regarding anatomical and pathophysiological clues to this are proposed, its exact mechanism remains unclear. The author presents a unique case of parkinsonism after shunting for hydrocephalus due to aqueductal stenosis with Chiari malformation. Suboccipital craniectomy and duraplasty followed by ventriculoperitoneal shunting was performed, parkinsonian symptoms developed after the shunt revision, and short-term levodopa therapy resulted in complete recovery.
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Role of Endoscopic Third Ventriculostomy in Shunt Malfunction
Shunt placement was a standard treatment for patients with hydrocephalus. It is indicated for both communicating and noncommunicating types of hydrocephalus and for various etiologies of hydrocephalus, including infection; congenital malformations, such as aqueductal stenosis, congenital cysts, mega cisterna magna, and Arnold-Chiari malformation; hemorrhage; and tumor. The risk of shunt malfunc...
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Aqueductal stenosis is responsible for 20% of cases of hydrocephalus. Its incidence ranges from 0.5 to 1.0 in 1,000 births, with a recurrence risk in siblings of 1.0% to 4.5%. The onset of symptoms is usually insidious and can occur at any time from birth to adulthood. Associated malformations in neighboring structures are common The presence of these malformations helps to explain the intellec...
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