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Progressive parkinsonism, balance difficulties, and supranuclear gaze palsy.
[cadasil]
A
76
-
year
-old
man
presented
with
a
4
-
year
history
of
a
progressive
parkinsonian
syndrome
.
It
started
with
slowness
of
gait
and
mood
dysfunction
.
Symptoms
slowly
progressed
and
further
included
occasional
unexplained
falls
.
On
examination
,
he
showed
a
severe
parkinsonian
syndrome
featuring
bradykinesia
,
rigidity
(
axial
 
&
gt
;
 
appendicular
)
,
and
positive
pull-test
finding
.
Moreover
,
there
was
an
upgaze
supranuclear
palsy
and
slow
saccades
on
vertical
plane
.
Magnetic
resonance
imaging
was
performed
that
revealed
significant
basal
ganglia
lesions
and
white
matter
hyperintensities
,
including
periventricular
regions
and
both
frontal
and
temporal
subcortical
areas
,
along
with
moderate
widespread
atrophy
and
ventricular
enlargement
.
Here
,
we
reveal
the
pathological
diagnosis
and
discuss
the
approach
to
the
clinical
data
.
Diseases
Validation
Diseases presenting
"ventricular enlargement"
symptom
cadasil
hydrocephalus with stenosis of the aqueduct of sylvius
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