Objectives: The purpose of this study is to analyse the clinical and neuroimaging features of patients with Vascular Parkinsonism

Background: Vascular Parkinsonism is a form of secondary Parkinsonism resulting from cerebrovascular disease. It is well known as a distinct entity, very different from   the classical syndrome of Parkinsons disease where the etiology is considered to be a degenerative process affecting the nigrostriatal dopaminergic pathways. Vascular Parkinsonism is considered as a form of secondary Parkinsonism, secondary to single or multiple vascular ischemic lesions. This study analyses the clinical features, neuro-imaging findings and risk factors of Vascular Parkinsonism among stroke patients. 

Materials and Methods: 163 patients with past history of stroke, attending the Stroke Clinic, Department of Medicine, Government Medical College, Thiruvananthapuram, Kerala between April 2013 and March 2014 were studied for features of Vascular Parkinsonism. The patients were clinically examined and the neuroimaging findings were recorded.

Results: 163 post-stroke patients were studied. Among them 40 patients (24.5%) had features of Vascular Parkinsonism. Patients with age above 70 years (p<0.001), multiple territory involvement, history of hypertension (p=0.002) were more prone to develop Vascular Parkinsonism. Stroke patients with Vascular Parkinsonism as compared to the tremor-dominant Parkinson’s Disease had statistically significant difference in the clinical features like early gait abnormality (p<0.001), lower limb predominance with frequent falls (p<0.001), postural instability (p<0.001), dementia (p<0.001) and urinary incontinence.

Conclusions: Elderly stroke patients with multiple territory involvement and with hypertension are more likely to develop Vascular Parkinsonism and their clinical profile is quite distinct from that of idiopathic Parkinson’s disease. Lower body parkinsonism and early involvement of gait leading to falls and early incontinence can be used as important differentiating features from the classical degenerative Parkinson’s disease

Keywords: Vascular Parkinsonism, Stroke, Neuroimaging.