Disproportionate bulbar dysfunction following small corona radiata infarction in vascular parkinsonism: A case report.
Hsiao-Wen Wang
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Case in brief
A 75-year-old woman with vascular parkinsonism presented with acute dysarthria, severe dysphagia necessitating nasogastric feeding, and significant gait instability. Brain MRI revealed a small acute infarction in the left corona radiata amidst extensive cerebral small vessel disease. Despite the small size of the infarct, she experienced profound swallowing dysfunction and impaired mobility. Following early multidisciplinary rehabilitation, she showed significant functional recovery at 3 months.
Diagnostic / clinical pearl
Small infarctions in the corona radiata can lead to disproportionately severe bulbar dysfunction in patients with vascular parkinsonism, highlighting the need for careful assessment and management.
Why it matters
This case underscores the importance of early multidisciplinary rehabilitation in achieving functional recovery, even in patients with diminished subcortical motor reserve.