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Clinicopathological investigation of vascular parkinsonism, including clinical criteria for diagnosis

Zijlmans, Jan C.M., Daniel, Susan E., Hughes, Andrew J., Révész, Tamas, Lees, Andrew J.·2004·Movement Disorders

Abstract

Vascular parkinsonism (VP) is difficult to diagnose with any degree of clinical certainty. We investigated the importance of macroscopic cerebral infarcts and pathological findings associated with microscopic “small vessel disease” (SVD) in the aetiology of VP. The severity of microscopic SVD pathology (perivascular pallor, gliosis, hyaline thickening, and enlargement of perivascular spaces) and the presence of macroscopically visible infarcts were assessed in 17 patients with parkinsonism and no pathological evidence of either Parkinson's disease or any histopathological condition known to be associated with a parkinsonian syndrome, and compared with age‐matched controls. Microscopic SVD pathology was significantly more severe in the parkinsonian brains. Most patients presented with bilateral bradykinesia and rigidity together with a gait disorder characterised predominantly by a shuffling gait. Four patients presented acutely with hemiparesis and then progressed to develop a parkinsonian syndrome. They could be distinguished from the remaining VP patients by the presence at autopsy of macroscopically visible lacunar infarcts in regions where contralateral thalamocortical drive might be reduced. The clinical features at presentation varied according to the speed of onset and the underlying vascular pathological state. New clinical criteria for a diagnosis of VP are proposed based on the clinicopathological findings of this study. © 2004 Movement Disorder Society

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Metadata

Authors
Zijlmans, J. C. M., Daniel, S. E., Hughes, A. J., Révész, T., & Lees, A. J.
Venue
Movement Disorders
Publisher
Wiley
Published
2004-03-16
Volume
19
Issue
6
Pages
630-640
ISSN
  • 0885-3185 (ISSN-L)
  • 1531-8257
OpenAlex
W1966760295
Cited by
383
References
55
FWCI
6.54
Type
journal article
Language
en
Open access
closed

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CoChat. (2026). Citation check: Clinicopathological investigation of vascular parkinsonism, including clinical criteria for diagnosis. https://app.cochat.ai/papers/10.1002/mds.20083
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Zijlmans, J. C. M., Daniel, S. E., Hughes, A. J., Révész, T., & Lees, A. J. (2004). Clinicopathological investigation of vascular parkinsonism, including clinical criteria for diagnosis. Movement Disorders. https://doi.org/10.1002/mds.20083

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