Lee Cheng-Chia, Lin Chun-Fu, Shih Yang-Hsin
Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
J Neurosci Rural Pract. 2011 Jul;2(2):193-4. doi: 10.4103/0976-3147.83593.
There have been few reports on secondary parkisonism caused by chronic subdual hemorrhage (CSDH). In most reports, rigidity-bradykinesia syndrome resolved gradually after decompressive operation for CSDH. We report a 74-year-old male patient who suffered from CSDH status post burr hole drainage twice, and followed secondary parkinsonism thereafter. Decompression by burr hole drainage was successful. However, the conscious level was still altered and the patient began to present with rigidity and bradykinesia. Fortunately, the symptoms dramatically improved after taking L-dopa. CSDH-related parkinsonism may have pre-operative nigrostriatal dysfunction, which can not compensate further insults to the basal ganglia. Prescription of L-dopa may be helpful in these patients.
关于慢性硬膜下血肿(CSDH)所致继发性帕金森综合征的报道较少。在大多数报道中,CSDH减压手术后,强直-运动迟缓综合征会逐渐缓解。我们报告一例74岁男性患者,曾两次接受钻孔引流治疗CSDH,之后出现继发性帕金森综合征。钻孔引流减压手术成功。然而,患者意识水平仍有改变,并开始出现强直和运动迟缓。幸运的是,服用左旋多巴后症状显著改善。CSDH相关的帕金森综合征可能术前存在黑质纹状体功能障碍,无法进一步代偿基底节受到的损伤。对这些患者使用左旋多巴治疗可能有效。