Session Information
Date: Monday, June 5, 2017
Session Title: Parkinsonism, MSA, PSP (Secondary and Parkinsonism-Plus)
Session Time: 1:45pm-3:15pm
Location: Exhibit Hall C
Objective: We report a case of intracranial dural arteriovenous fistula (DAVF) presenting sudden onset of isolated parkinsonism.
Background: Common initial symptoms in DAVF are pulsatile tinnitus, cranial nerve palsy, headache, convulsion, and cognitive deficit. Parkisonism associated with DAVF are rare. To our knowledge, only one case of isolated parkinsonism due to DAVF has been reported.
Methods: Case report with retrospetive review of relevant clinical, imaging and treatment data.
Results: A 67-year-old man developed sudden onset of bradykinesia, and was admitted to a local hospital on November 4th, 20XX-1. He had a history of mild renal failure. On the neurological examination, he presented parkinsonism including bradykinesia and muscle rigidity. Brain MRI and 3D-CT angiography were performed. Since renal failure worsened after 3D-CT angiography, he was transferred to another hospital for treatment. He was discharged from the hospital with improvement of renal failure 3 months later. He visited our hospital on March 3th, 20XX. His consciousness level was alert, and cognitive function was well preserved. He showed isolated parkinsonism including masked face, small voice, rigidity with a dominancy on the left side, and postural instability. Diffusion MRI and T2 weight MRI revealed high signal intensity in the bilateral globus pallidus. The (123) I-FP-CIT SPECT showed a decreased uptake in the bilateral striatum with a dominancy in the left side. MRI angiography revealed that DAVF in the right transverse-sigmoid sinus was fed by the right occipital artery with a reflux upstream toward the straight sinus and the vein of Galen. His symptoms gradually progressed during the initial one month, but began to improve at four month after the onset. His parkinsonism did not respond to levodopa. Endovascular embolization of the fistula slightly improved his parkinsonism and the high signal intensity of the bilateral globus pallidus on the brain MRI disappeared.
Conclusions: DAVF may cause sudden onset of isolated parkinsonism.
To cite this abstract in AMA style:
H. Kawasaki, T. Yamamoto, A. Miyake, K. Ikeda, T. Mistuhuji, Y. Ito, K. Takahashi, N. Tamura, N. Araki. Sudden onset of parkinsonism in a case of dural arteriovenous fistula [abstract]. Mov Disord. 2017; 32 (suppl 2). https://www.mdsabstracts.org/abstract/sudden-onset-of-parkinsonism-in-a-case-of-dural-arteriovenous-fistula/. Accessed May 22, 2025.« Back to 2017 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/sudden-onset-of-parkinsonism-in-a-case-of-dural-arteriovenous-fistula/