Abstract

Objectives: In this study, we aimed to evaluate extrapyramidal symptoms and investigate whether vascular parkinsonism (VP) developed in patients with subcortical gray matter ischemic lesions.

Patients and Methods: Between January 2006 and October 2008, 43 patients of 638 patients with subcortical gray matter ischemic lesions and with a Rankin’s score of less than 3 (23 males, 20 females; mean age 64±3 years; range 58 to 89 years) and who were followed up at least three months following ischemic stroke were included. The patients were divided into three subgroups: (i) patients with unilateral basal ganglia lesions (group 1; n=20); (ii) patients with thalamus lesions (group 2; n=11); (iii) patients with bilateral basal ganglia lesions (group 3; n=12). All three groups were evaluated in terms of the presence of extrapyramidal symptoms and VP.

Results: In group 1, three patients (15%) had anteflexion posture and two patients (10%) had bradykinesia, while six patients (30%) had rigidity. In group 2, anteflexion posture was observed in one patient (9.1%) and bradykinesia was seen in two patients (18.2%), while rigidity was present in two patients (18.2%). In group 3, anteflexion posture and bradykinesia were found in seven (58.3%) and eight patients (66.6%), respectively. In addition, rigidity was seen in eight patients (66.6%), while gait disorder was found in seven patients (58.3%). Gait disorder was not seen in group 1 and group 2 whereas tremor was not observed in any group. The incidence of bradykinesia and gait disorder were significantly higher in group 3.

Conclusion: Our results showed that bilateral subcortical gray matter lesions led to more severe extrapyramidal symptoms, suggesting evidence for VP.