Parkinsonism after Shunting for Hydrocephalus Secondary to Aqueductal Stenosis with Chiari Malformation

Parkinsonism has been well-documented in patients with communicating hydrocephalus, but it is an uncommon complication of shunting for obstructive hydrocephalus secondary to aqueductal stenosis. Although a number of hypotheses regarding anatomical and pathophysiological clues to this are proposed, its exact mechanism remains unclear. The author presents a unique case of parkinsonism after shunting for hydrocephalus due to aqueductal stenosis with Chiari malformation. Suboccipital craniectomy and duraplasty followed by ventriculoperitoneal shunting was performed, parkinsonian symptoms developed after the shunt revision, and short-term levodopa therapy resulted in complete recovery.