Department of Neurology, Medical University Innsbruck, Anichstrasse 35, Innsbruck, Austria.
Department of Neurology, Medical University Regensburg, Universitätsstraße 84, 93053, Regensburg, Germany.
BMC Neurol. 2020 Mar 12;20(1):89. doi: 10.1186/s12883-020-01670-y.
Intracranial neoplasms are an uncommon cause of symptomatic parkinsonism. We here report a patient with an extensive middle and posterior fossa arachnoid cyst presenting with parkinsonism that was treated by neurosurgical intervention.
Retrospective chart review and clinical examination of the patient.
This 55-year-old male patient with hemiparkinsonism and recurrent bouts of headaches was first diagnosed in 1988. CT scans revealed multiple cystic lesions compressing brainstem and basal ganglia, which were partially resected. Subsequently, the patient was free of complaints for 20 years. In 2009 the patient presented once more with severe unilateral tremor and thalamic pain affecting the right arm. Despite symptomatic treatment with L-Dopa and pramipexole symptoms worsened over time. In 2014 there was further progression with increasing hemiparkinsonism, hemidystonia, unilateral thalamic pain and pyramidal signs. Repeat CT scanning revealed a progression of the cysts as well as secondary hydrocephalus. Following repeat decompression of the brainstem and fenestration of all cystic membranes parkinsonism improved with a MDS- UPDRS III score reduction from 39 to 21. Histology revealed arachnoid cystic material.
We report on a rare case of recurrent symptomatic hemiparkinsonism resulting from arachnoid cysts.
颅内肿瘤是引起症状性帕金森病的不常见原因。我们在此报告一例广泛的中后颅窝蛛网膜囊肿患者，其表现为帕金森病，并接受了神经外科干预治疗。
回顾性病历审查和患者临床检查。
这名 55 岁男性患者表现为偏瘫性帕金森病和反复发作的头痛，于 1988 年首次诊断。CT 扫描显示多个囊性病变压迫脑干和基底节，这些病变部分被切除。随后，患者 20 年来无任何不适。2009 年，患者再次出现严重的单侧震颤和影响右臂的丘脑疼痛。尽管采用 L-Dopa 和普拉克索进行对症治疗，但症状随时间推移而恶化。2014 年，偏瘫性帕金森病、半身性肌张力障碍、单侧丘脑痛和锥体束征进一步加重。重复 CT 扫描显示囊肿进展以及继发性脑积水。再次进行脑干减压和所有囊肿膜开窗术后，帕金森病得到改善，MDS-UPDRS III 评分从 39 分降至 21 分。组织学显示蛛网膜囊性物质。
我们报告了一例罕见的复发性症状性偏瘫性帕金森病，由蛛网膜囊肿引起。
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