A Stroke Can Cause Vascular Parkinsonism

An elderly patient talks with her doctor.
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Parkinson's disease is a fairly common neurological disease that causes a number of symptoms, most characteristically tremors and slow movements of the limbs. Parkinson's disease is a slowly worsening condition caused by progressive degeneration of certain areas of the brain. It is not known why some people develop Parkinson's disease.

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.

Other signature signs of Parkinson’s disease are bradykinesia (slowness of movement), rigidity, and postural instability. People who have Parkinsonism may exhibit all or a combination of these symptoms. Parkinson's disease and Parkinsonism may cause difficulty initiating movements, slowness of movements, stiff muscle tone which makes walking and moving extremely difficult, and an 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.

Some conditions can cause Parkinsonism by suddenly damaging the substantia nigra or the basal ganglia. 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.

Parkinson's Disease Caused by Stroke: Vascular Parkinsonism

When the substantia nigra or basal ganglia is affected by a stroke, this is called vascular Parkinsonism, since it is caused by a lack of blood supply to these regions of the brain. Generally, it is small strokes, which are often termed small vessel strokes, that are associated with Parkinsonism. This diagnosis of small vessel strokes can be supported by diagnostic tests such as CT or MRI of the brain.

Commonly, it takes several small strokes to produce the symptoms of vascular Parkinsonism. Sometimes these small strokes also produce a type of dementia called vascular dementia. It is not unusual for people who have vascular Parkinsonism to also have vascular dementia.

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, causing 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 doctor 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 moderate exercise and quitting smoking if you smoke. Eating a healthy diet is also important: find out more about healthy cooking oils and learn more about how cholesterol impacts your risk of stroke.

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