Akinetic Mutism Responsive to Bromocriptine Following Subdural Hematoma Evacuation in a Patient With Hydrocephalus -Case Report-

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  • KIM Myoung Soo
    Department of Neurosurgery, Seoul Paik Hospital, Inje University College of Medicine
  • RHEE Jong Joo
    Department of Neurosurgery, Seoul Paik Hospital, Inje University College of Medicine
  • LEE Seung Jun
    Department of Neurosurgery, Seoul Paik Hospital, Inje University College of Medicine
  • KWON Seon-Joo
    Department of Neurology, Seoul Paik Hospital, Inje University College of Medicine
  • LEE Chae Heuck
    Department of Neurosurgery, Seoul Paik Hospital, Inje University College of Medicine

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  • —Case Report—

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An 11-year-old girl with obstructive hydrocephalus developed akinetic mutism after treatment for hydrocephalus due to aqueductal stenosis by ventriculoperitoneal (VP) shunting. Bilateral chronic subdural hematomas developed about 2 months after insertion of the VP shunt and were evacuated. Postoperatively, the patient developed akinetic mutism, but her condition improved after administration of bromocriptine. Absence of abnormalities on dopamine transporter single photon emission computed tomography, lack of clinical response to levodopa treatment, and normal homovanillic acid concentration in the cerebrospinal fluid all indicated normal dopamine production. Pressure on the periventricular monoamine projections in the thalamus and hypothalamus without major dopamine deprivation in the striatum may have been the most important factors in the development of akinetic mutism in this patient.<br>

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