水腦症的典型臨床症狀為步行困難、記憶力衰退與失禁;帕金森症候群合併7位腦症在臨床上並不罕見O然而其致病機轉並不清楚，且無特別診斷工具，完全仰賴症狀觀察。我們報告了兩位以純粹怕金森症狀為表現的病怠，並以鎝-99m- TRODAT-I的單光子射出斷層攝影，來評估黑質及紋狀體系統在水腦導致的中白金森症候群中所受的影響。兩位病患的帕金森症狀以左多巴之治療均無效，但施以腦室腹膜分流手術後其症狀則有明顯改善。其鎝-99m-TRODAT-I的單 光子射出斷層攝影的影像與正常人相較完全相同而其值達較帕金森病病人為高。因此我們推論這兩位病患由水腦導致的帕金森症狀，與帕金森病不同，與中腦的黑質細胞無關。並且鎝-99m-TRODAT-I的單光子射出斷層攝影將有助於鑑 別診斷水腦導致的怕金森症和其他的退化性疾病如帕金森病和漸進性核上麻痺症等，並可作為手術或藥物治療的參考。

Hydrocephalus is often characterized by gait disturbance， cognitive dysfunction， and/or urinary incontinence in the elderly. Parkinsonian syndromes associ ated with hydrocephalus are not uncommon. The pathogenesis is still unclear and the diagnosis is based on clinical observations. To investigate the nigrostriatal involvement in parkinsonian syndromes associated with hydrocephalus， we studied single photon emission computed tomography (SPECT) imaging with [2-[[2-[[[3- (4-chlorophenyl)-8-methyl-8-azabicyclo [3.2.1] oct-2-yl] methyl] (2-mercaptoethyl) amino] ethyl] amino] ethaneth iolato (3-)-爪，N2'，S;]oxo-[1 R-(exo-exo)][99mTc]technetium ("9mTc-TRODAT-1) in two cases of hydrocephalus associated with marked parkinsonism. One case showed asymmetric rigidity with gait disturbance. Another case showed tremor， rigidity， akinesia but only mild gait disturbance. None of them had dementia or incontinence. Magnetic resonance imaging (MRI) of brain revealed non-obstructive hydrocephalus. The parkinsonian features didrγt response to levodopa treatment but improved after shunting procedures in both cases. 99mTc-TRODA下1 SPECT imaging revealed no significant reduction of 99mTc-TRODA下1 uptake in both the caudate and putamen. It suggested that the presynaptic dopaminergic deficit was not the cause of parkinsonian syndromes associated with hydrocephalus in our patients. The report is the first report to discuss the function of the dopamine transports by SPECT imaging in the patients of hydrocephalus. We concluded that 99mTc-TRODA下1 SPECT imaging might be useful in differential diagnosis of parkinsonian syndromes secondary to hydrocephalus and idiopathic Parkinsorγs disease.