Vascular
Parkinsonism (VP) is a form of
secondary Parkinsonism resulting from
cerebrovascular disease. Estimates of the frequency of VP vary greatly worldwide; 3% to 6% of all cases of
Parkinsonism are found to have a vascular etiology. In a Brazilian community-based study on
Parkinsonism, 15.1% of all cases were classified as VP, the third most common form, with a prevalence of 1.1% in an elderly cohort. Another Brazilian survey found a prevalence of 2.3% of VP in the elderly. VP is usually the result of conventional vascular risk factors, particularly
hypertension, leading to strategic
infarcts of subcortical gray matter nuclei, diffuse white matter ischaemic lesions and less commonly, large vessel
infarcts. Patients with VP tend to be older and present with gait difficulties, symmetrical predominant lower-body involvement, poor
levodopa responsiveness, postural instability, falls,
cognitive impairment and
dementia, corticospinal findings,
urinary incontinence and
pseudobulbar palsy. This article intends to provide physicians with an insight on the practical issues of VP, a disease potentially confounded with
vascular dementia,
idiopathic Parkinson's disease,
dementia with Lewy bodies and other secondary causes of
Parkinsonism.