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Case Reports in Neurological Medicine
Volume 2015 (2015), Article ID 642764, 3 pages
http://dx.doi.org/10.1155/2015/642764
Case Report

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

Movement Disorders Center, Department of Neurology, Institute of Neurology, University of Cagliari, Monserrato, 09042 Cagliari, Italy

Received 25 May 2015; Revised 26 August 2015; Accepted 16 September 2015

Academic Editor: Pablo Mir

Copyright © 2015 Paolo Solla et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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 123I-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.