Institute: Department of Neurology, The Affiliated Hospital of Jiujiang University, Address: No.57 Xunyang East Rode, Xunyang District, Jiujiang 332000, Jiangxi Province, China.
Institute: Department of Neurology, The People's Hospital of Xinyu City, Address: No.369 Xinxin North Rode, Yushui District, Xinyu 338000, Jiangxi Province, China.
J Neurol Sci. 2018 May 15;388:182-185. doi: 10.1016/j.jns.2018.03.027. Epub 2018 Mar 20.
Wallerian degeneration (WD) of middle cerebellar peduncles (MCPs) secondary to pontine infarction is rarely reported in the literature. Our aim in this study is to characterize its clinical and neuroradiological features.
A retrospective review of 7 patients from a single institution was conducted. Only patients with pontine infarction and subsequent degeneration of the MCPs were included in the analysis. The features of clinical presentation and neuroimaging finding were summarized by our experienced neurologists.
Seven patients (5 male, 2 female), ranging in age from 50 to 77 years, satisfied the inclusion criteria. All patients had cardiovascular risk factors and hypertension was the most common one. Almost all of the patients had hemiparesis and dysarthria, and could achieved good clinical outcome. On the initial scan, hyperintense on T2- and diffusion-weighted images suggested the acute pontine infarction. On the follow-up scan, however, hyperintensities of bilateral MCPs on T2-weight and FLAIR images were apparently demonstrated in all patients. The specific lesions in the MCPs were attributed to bilateral WD of the pontocerebellar fibres secondary to pontine infarction.
WD should be taken into account when patients are initially diagnosed with paramedian pontine infarction and follow-up MRI manifest as symmetrical hyperintense in the MCPs.
桥脑梗死继发的小脑中脚（MCP）的沃勒氏变性（WD）在文献中很少报道。我们旨在本研究中描述其临床和神经影像学特征。
对单中心的 7 例患者进行回顾性研究。仅纳入分析存在桥脑梗死和随后的 MCP 变性的患者。由我们经验丰富的神经科医生总结临床表现和神经影像学发现的特征。
7 例患者（5 男，2 女），年龄 50-77 岁，符合纳入标准。所有患者均有心血管危险因素，高血压最常见。几乎所有患者均有偏瘫和构音障碍，并获得良好的临床转归。在初始扫描中，T2 加权和弥散加权图像上的高信号提示急性桥脑梗死。然而，在随访扫描中，所有患者的双侧 MCP 在 T2 加权和 FLAIR 图像上均明显显示高信号。MCP 中的特定病变归因于桥脑梗死继发的桥脑小脑纤维的双侧 WD。
当患者最初被诊断为旁正中桥脑梗死，并且随访 MRI 显示 MCP 呈对称性高信号时，应考虑 WD。
