Secondary Parkinsonism in a Patient With a Cerebral Cavernous Hemangioma Treated With Stereotactic Radiosurgery

Abstract

Secondary parkinsonism is defined with some symptoms similar to idiopathic Parkinson's disease, but with different etiologies. And cerebral cavernous hemangioma is one of the rare cases. A 51-year-old, male patient was consulted with tremor, rigidity and bradykinesia on the right upper extremity. The Hoehn and Yahr Parkinson's scale was Stage І. Radiological evaluations showed a deep-seated cerebral cavernous hemangioma at the left posterior insular region. The patient received stereotactic radiosurgery (CyberKnife®, Accuray Incorporated, Sunnyvale, CA, USA). Clinical and radiological improvements revealed within follow-up, respectively. Stereotactic radiosurgery may be an alternative treatment for secondary parkinsonism by reducing the risk of re-bleeding and reducing its size.

Hemiparkinsonism caused by a lateral sphenoid wing meningioma, with tractography analysis: illustrative case

“…Besides meningioma, other entities such as various CNS tumors, large arachnoid cysts, giant aneurysms, cavernoma, and chronic subdural hematoma have been reported to potentially cause secondary parkinsonism. 3,4,6,[11][12][13] The mechanisms causing extrapyramidal symptoms can be direct pressure to the basal ganglia nuclei, compression of midbrain structures, or damage to white matter tracts connecting the basal ganglia and cortical/mesencephalic areas. In our literature search, we found only one publication reporting the use of DTI analysis with the aim to visualize the corticospinal tract for surgical planning, rather than to understand the pathophysiology.…”