A Stroke Can Cause Vascular Parkinsonism

Parkinsonism, a condition that impacts movement, has similar symptoms to Parkinson's disease. A stroke involving the substantia nigra or basal ganglia is called vascular Parkinsonism. Similar to other strokes, the damage is caused primarily by a lack of blood supply to these brain regions.

The strokes associated with Parkinsonism are termed small vessel strokes as they aren't normally catastrophic. It typically takes several small strokes to produce the symptoms of vascular Parkinsonism. Diagnosis of small vessel strokes can be confirmed with tests such as CT or MRI of the brain.

This article discusses stroke and Parkinsonism, treatment, and more.

A patient talks with her doctor
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In some cases, small vessel strokes can also produce a type of dementia called vascular dementia. As such, it is not unusual for people with vascular Parkinsonism to also have vascular dementia.

Parkinson's Disease and Parkinsonism

There is also another similar disease called Parkinsonism, which is a condition in which people have some of the symptoms of Parkinson's disease, but do not have Parkinson's disease itself. Parkinsonism occurs when one or more of the regions of the brain that are responsible for Parkinson's disease become damaged.

One of the early symptoms of Parkinson's disease is a loss of the sense of smell, which can happen years before other symptoms appear. The symptoms of Parkinson's disease and Parkinsonism also include a fine tremor, which is very noticeable in the hands and arms and happens when the hands and arms are at rest.

Beyond loss of sense of smell and tremor, Parkinson's is associated with several other physical symptoms, including slowness of movement (bradykinesia), rigidity (stiff muscles) and postural instability. These symptoms can make walking or generally moving around extremely difficult and can lead to abnormal body posture. Additionally, people who have Parkinson's disease or Parkinsonism often have very little facial expression, which is typically called a "masked face."

The areas of the brain involved in Parkinson's disease and Parkinsonism are called the substantia nigra and the basal ganglia. Parkinson's disease is normally caused by slowly progressive degeneration of these two areas, which control the rhythm and smoothness of our movements and the tone of our muscles. As the substantia nigra and the basal ganglia degenerate, the typical symptoms of Parkinson's disease begin to emerge.

Certain health conditions or sudden damage to the substantia nigra or the basal ganglia are associated with onset of Parkinsonism. These conditions include head trauma, brain tumors, infections in the brain, and stroke. Most of the time, the symptoms of Parkinsonism appear when injury or damage to the brain occurs, rather than in the gradual progression characteristic of Parkinson's disease.

Treatment of Vascular Parkinsonism

The most commonly used medications for vascular Parkinsonism are L-dopa and amantadine. However, some people with Parkinsonism do not experience significant improvement with medication. Some stroke survivors who have vascular Parkinsonism can experience better muscle control with physical therapy. Often, safety measures need to be taken to avoid falls.

If you have already had recurrent strokes resulting in vascular Parkinsonism, you may be at risk of experiencing more strokes over the coming years if no action is taken to reduce your risk. Therefore, if you have been diagnosed with vascular Parkinsonism, it is particularly important to follow up with your healthcare provider in order to prevent additional strokes. You should expect to have testing for stroke risk factors and medical treatment to reduce your risk of stroke.

There are also a number of lifestyle factors that can help reduce stroke risk, such as getting regular moderate exercise and quitting smoking if you smoke. Eating a healthy diet is also important.

7 Sources
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Additional Reading

By Jose Vega MD, PhD
Jose Vega MD, PhD, is a board-certified neurologist and published researcher specializing in stroke.