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 there are three different pathologic states that produce vascular parkinsonism vp including multiple lacunar infarctions in the basal ganglia area subcortical arteriosclerotic changes binswanger's disease and a single vascular lesion that present a clinical picture indistinguishable from parkinson's disease parkinson's disease symptoms occur in vascular parkinsonism however resting tremor is either reduced or absent only a minority but a large minority of people with vascular parkinsonism respond to l dopa archives of neurology e d louis j a luchsinger journal of neurology supplement iii iii k fukimoto journal of neurology i sibon g fenelon n p quinn f tison journal of clinical neuroscience s peters e g eising h przuntek t muller di yi jun yi da xue xue bao d q zhao archives of neurology j winikates j jankovic acta neurologica scandinavica c m chang y l yu h k ng s y leung k y fong stroke h yamanouchi h nagura journal of neurology lrampello a alvano g battaglia r raffaele i vecchio m malaguarnera journal of neurological and neurosurgical psychiatry j c zijlmans r katzenschlager s e daniel a j lees acta neurologica scandinavica m demirkiran m bozdemir h sarica y movement disorders 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