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[Rapidly progressive parkinsonism that developed one year after ventriculoperitoneal shunting for idiopathic aqueductal stenosis: a case report].
[hydrocephalus with stenosis of the aqueduct of sylvius]
A
46
-
year
-old
woman
was
diagnosed
with
having
idiopathic
aqueductal
stenosis
for
which
she
underwent
ventriculoperitoneal
(
V-P
)
shunting
.
One
year
after
the
surgery
,
she
developed
acute
parkinsonism
and
sylvian
aqueduct
syndrome
.
Brain
magnetic
resonance
imaging
(
MRI
)
did
not
reveal
any
signs
of
hydrocephalus
and
fluorodopa
positron
emission
tomography
(
PET
)
did
not
reveal
any
decrease
in
accumulation
of
fluorodopa
at
the
striatum
.
On
admission
,
the
Unified
Parkinson
Disease
Rating
Scale
(
UPDRS
)
(
Part
III
)
score
was
30
points
.
The
preliminary
diagnosis
was
parkinsonism
associated
with
V-P
shunting
:
therefore
,
the
levodopa
dosage
was
increased
from
200
mg
/
day
to
600
mg
/
day
.
Thereafter
,
the
symptoms
of
parkinsonism
and
the
sylvian
aqueduct
syndrome
markedly
improved
,
and
the
UPDRS
(
Part
III
)
score
decreased
.
If
such
a
patient
presents
without
signs
of
hydrocephalus
or
shunt
malfunction
,
dopaminergic
medication
should
be
used
as
the
initial
treatment
.