Clinical and imaging features of Wallerian degeneration after stroke in adults: a study of 4 cases
10.3760/cma.j.issn.1673-4165.2020.05.008
- VernacularTitle:成年人卒中后华勒变性的临床和影像学特征：4例病例系列研究
- Author:
Yue ZHAO
1
;
Guorong BI
Author Information
1. 中国医科大学附属盛京医院滑翔分院神经内科，沈阳 110022
- From:
International Journal of Cerebrovascular Diseases
2020;28(5):360-364
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical and imaging features of Wallerian degeneration in adults with stroke.Methods:Adult stroke patients with Wallerian degeneration admitted to Shengjing Hospital of China Medical University from October 2018 to September 2019 were enrolled retrospectively. Combined with the related literature, the clinical and imaging features of Wallerian degeneration after stroke were investigated.Results:A total of 4 patients with Wallerian degeneration after stroke were enrolled, including 3 males and 1 female, aged 56-63 years. The main clinical symptoms were dysarthria ( n=3), poor physical activity ( n=3), dysphagia ( n=1), and dizziness ( n=1). The National Institutes of Health Stroke Scale score was 1-6. The initial MRI and CT findings after stroke were consistent with the diagnosis of acute cerebral infarction. During the follow-up of 3 to 7 months after the onset, MRI revealed Wallerian degeneration, which showed hyperintensities along nerve fibers on T 2 and Fluid-Attenuation Inversion Recovery (FLAIR) sequence images. Diffusion-Weighted Imaging (DWI) in almost all cases also found hyperintensities along nerve fibers. Conclusions:After acute stroke (including ischemic and hemorrhagic stroke) in the territory of the internal carotid artery, ipsilateral pyramidal tract damage may occur, affecting the long-term motor function of patients. After unilateral pontine stroke, bilateral pontine arm damage may occur, affecting ataxia and balance function of the patients. Wallerian degeneration after stroke is a special neurodegenerative process. Its imaging manifestations are similar to those of new cerebral infarction. Correct understanding of this phenomenon can avoid misdiagnosis.
