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. 2015:2015:642764.
doi: 10.1155/2015/642764. Epub 2015 Oct 15.

Focal (123)I-FP-CIT SPECT Abnormality in Midbrain Vascular Parkinsonism

Paolo Solla  1 , Antonino Cannas  1 , Roberta Arca  1 , Davide Fonti  1 , Gianni Orofino  1 , Francesco Marrosu  1
Affiliations

Focal (123)I-FP-CIT SPECT Abnormality in Midbrain Vascular Parkinsonism

Paolo Solla et al. Case Rep Neurol Med. 2015.

Abstract

Cerebrovascular diseases are considered among possible causes of acute/subacute parkinsonism, representing up to 22% of secondary movement disorders. In cases of suspected vascular parkinsonism (VP), dopamine transporter SPECT has been highly recommended to exclude nigrostriatal dopaminergic degeneration. We report the case of a hemiparkinsonism related to a left midbrain infarct with focal lateralized putaminal abnormalities at (123)I-FP-CIT SPECT imaging. The asymmetric uptake at dopamine transporter SPECT was different to findings commonly observed in typical PD pattern, because the ipsilateral striatum, in opposite to idiopathic PD, showed normal tracer binding. However, this selective parkinsonism after infarction of the midbrain was responsive to levodopa. In conclusion, we retain that there is a need of more functional imaging studies in VP addressed to a more consistent classification of its different clinical forms and to a better understanding of the adequate pharmacological management.

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Figures

Figure 1
Figure 1
Cranial MRI revealed a lacunar infarction localized in the left midbrain (arrow) appearing hyperintense in T2 sections.
Figure 2
Figure 2
123I-FP SPECT showing a reduced tracer binding in the left striatum, with a more marked reduction in the putamen.
See this image and copyright information in PMC

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