Parkisonism followed by burr hole drainage for chronic subdural hemorrhage

Abstract

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.