Vascular Parkinsonism Vascular parkinsonism is produced by one or more small strokes that affect the basal ganglia A stroke is the loss of activity of a discreet brain area lesion because of blockage of the blood supply to that brain region Vascular diseases are associated with a higher prevalence of Parkinson s Disease 1 There are three different pathologic states that produce Vascular Parkinsonism VP including multiple lacunar infarctions in the basal ganglia area 2 3 subcortical arteriosclerotic changes Binswanger s disease 2 3 and a single vascular lesion that present a clinical picture indistinguishable from Parkinson s disease 2 3 4 Parkinson s Disease symptoms occur in Vascular Parkinsonism 5 12 However resting tremor is either reduced 5 6 or absent 7 8 Only a minority but a large minority of people with Vascular Parkinsonism respond to L dopa 9 10 1 Archives of Neurology 2006 63 5 717 722 E D Louis J A Luchsinger 2 Journal of Neurology 2006 253 Supplement 3 iii16 iii21 K Fukimoto 3 Journal of Neurology 2004 251 5 513 524 I Sibon G Fenelon N P Quinn F Tison 4 Journal of Clinical Neuroscience 2001 8 3 268 271 S Peters E G Eising H Przuntek T Muller 5 Di Yi Jun Yi Da Xue Xue Bao 2005 25 7 868 870 D Q Zhao 6 Archives of Neurology 1999 56 1 98 102 J Winikates J Jankovic 7 Acta Neurologica Scandinavica 1992 86 6 588 592 C M Chang Y L Yu H K Ng S Y Leung K Y Fong 8 Stroke 1997 28 5 965 969 H Yamanouchi H Nagura 9 Journal of Neurology 2005 252 9 1045 1049 LRampello A Alvano G Battaglia R Raffaele I Vecchio M Malaguarnera 10 Journal of Neurological and Neurosurgical Psychiatry 2004 75 4 545 547 J C Zijlmans R Katzenschlager S E Daniel A J Lees 11 Acta Neurologica Scandinavica 2001 104 2 63 67 M Demirkiran M Bozdemir H Sarica Y 12 Movement Disorders 1996 11 5 501 508 J C Zijlmans P J Poels J Duysens J van der Straaten T Thien M A van t Hof H O Thijssen M W Horstink