Department of Neurology, Hallym University College of Medicine, Seoul, Korea.
J Clin Neurol. 2012 Dec;8(4):308-10. doi: 10.3988/jcn.2012.8.4.308. Epub 2012 Dec 21.
Exofocal neuronal death in the substantia nigra (SN) is a well-known form of anterograde transsynaptic cell death. Exofocal neuronal death could theoretically also occur in the globus pallidus (GP) after striatal injury.
Case 1. A 70-year-old woman visited the emergency room because of decreased mentality. On admission, blood-gas analysis indicated that her oxygen tension was 69.1 mm Hg. The caudate nucleus, putamen, and temporooccipital cortex on both sides of the brain exhibited high-intensity diffusion-weighted magnetic resonance imaging (MRI) signals. At 10 days after admission, new high-intensity signals had developed in the SN and GP on both sides. Case 2. A 48-year-old man visited the emergency room because of right-sided weakness. Lesions were noted in the left caudate nucleus and putamen. At 4 days after admission, newly developed high-intensity MRI signals were observed in the left SN and GP.
Exofocal neuronal death can occur in the GP as well as in the SN; these findings need to be clearly distinguished from those of recurrent ischemic injuries, such as recurrent stroke.
黑质（SN）中的远隔神经元死亡是一种众所周知的顺行性跨突触细胞死亡形式。理论上，在纹状体损伤后，苍白球（GP）也可能发生远隔神经元死亡。
病例 1。一位 70 岁女性因精神状态下降而到急诊就诊。入院时，血气分析表明其氧分压为 69.1mmHg。大脑双侧的尾状核、壳核和颞枕叶皮质显示出高弥散加权磁共振成像（MRI）信号。入院后 10 天，双侧 SN 和 GP 出现新的高强度信号。病例 2。一位 48 岁男性因右侧无力而到急诊就诊。左尾状核和壳核有病变。入院后 4 天，左 SN 和 GP 出现新的高强度 MRI 信号。
远隔神经元死亡可发生在 GP 以及 SN 中；这些发现需要与复发性缺血性损伤（如复发性中风）明显区分。
