Clinical characteristics of bilateral Wallerian degeneration in the middle cerebellar peduncles after paramedian pontine infarction
10.3760/cma.j.issn.1671-8925.2017.05.016
- VernacularTitle:脑桥梗死后双侧对称性小脑中脚华勒变性的临床特点
- Author:
Daopei ZHANG
1
;
Meng YU
;
Suo YIN
;
Shuling ZHANG
Author Information
1. 郑州人民医院神经内科
- Keywords:
Pontine infarction;
Middle cerebella peduncle;
Wallerian degeneration;
Magnetic resonance imaging
- From:
Chinese Journal of Neuromedicine
2017;16(5):523-526
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the pathological process of MR imaging and clinical characteristics of bilateral Wallerian degeneration (WD) in the middle cerebellar peduncles after pontine infarction.Methods The present article reported one patient with paramedian pontine infarction who complicated bilateral WD in the middle cerebellar peduncles after 6 months;the major data included multimode MR imaging,brainstem auditory evoked potential and blink reflex.And then,these English and Chinese literature which reported 16 patients were reviewed together.The clinical,pathology and imaging characteristics of the 17 patients were summarized.Results Seventeen patients were all paramedian pontine infarction before finding WD:5 were on the right side and 11 were on the left side and one was bilateral side.When WD was found,original symptoms of pontine infarction were aggravated in 4 patients,one appeared dizziness and 12 were without symptoms.Thirteen patients had good prognosis,and the other 4 patients involved a poor prognosis because of severe primary lesions.Wallerian degeneration were found fiom 3 weeks to 33 weeks:2 were found DWI high signal in the bilateral middle cerebellar peduncles within four weeks after pontine infarction which attributed to first stage ofWD;4 had high MRI T2 signal close to 14 weeks which were in the second stage of WD;there were 11 with high T2 and FLAIR signal,low or equal apparent diffusion coefficient signal within 16 weeks after pontine infarction which were in the third stage of WD.No cases were in the fourth stage of WD.Conclusions Bilateral symmetry WD in the middle cerebellar peduncles is easily consolidated unilateral paramedian pontine infarction.The majority of these patients can be free for clinical symptoms and MR imaging features are usually in stage 2 and stage 3 of WD.These conditions have good clinical outcomes and should be paid more attention and avoided inappropriate treatments.
