Raeder Mariana Trombetta de Lima, Reis Eduardo Pontes, Campos Brunno Machado, Zamilute Igor Aloísio Garcez, França Júnior Marcondes Cavalcante, Reis Fabiano
Departamento de Radiologia, Universidade Estadual de Campinas, Campinas, SP, Brazil.
Departamento de Neurologia, Universidade Estadual de Campinas, Campinas, SP, Brazil.
Arq Neuropsiquiatr. 2020 May;78(5):301-306. doi: 10.1590/0004-282x20200021. Epub 2020 Jun 1.
Transaxonal degenerations result from neuronal death or the interruption of synaptic connections among neuronal structures. These degenerations are not common but may be recognized by conventional magnetic resonance imaging.
The learning objectives of this review include recognition of the imaging characteristics of transaxonal degenerations involving cerebellar connections, the identification of potential encephalic lesions that can lead to these degenerations and correlation of the clinical manifestations with imaging findings that reflect this involvement.
In this report, we review the neuroanatomical knowledge that provides a basis for identifying potential lesions that can result in these degenerations involving cerebellar structures.
Hypertrophic olivary degeneration results from an injury that interrupts any of the components of the Guillain-Mollaret triangle. In this work, we describe cases of lesions in the dentate nucleus and central tegmental tract. The crossed cerebellar diaschisis presents specific imaging findings and clinical correlations associated with its acute and chronic phases. The Wallerian degeneration of the middle cerebellar peduncle is illustrated by fiber injury of the pontine cerebellar tracts. A T2-hyperintensity in the dentate nucleus due to a thalamic acute lesion (in ventral lateral nuclei) is also described. Each condition described here is documented by MRI images and is accompanied by teaching points and an anatomical review of the pathways involved.
Neurologists and radiologists need to become familiar with the diagnosis of these conditions since their presentations are peculiar and often subtle, and can easily be misdiagnosed as ischemic events, degenerative disease, demyelinating disease or even tumors.
跨神经元变性是由神经元死亡或神经元结构之间突触连接中断引起的。这些变性并不常见，但可通过传统磁共振成像识别。
本综述的学习目标包括识别涉及小脑连接的跨神经元变性的影像学特征，确定可导致这些变性的潜在脑部病变，以及将临床表现与反映这种受累情况的影像学表现相关联。
在本报告中，我们回顾了神经解剖学知识，这些知识为识别可能导致涉及小脑结构的这些变性的潜在病变提供了基础。
肥大性橄榄核变性是由损伤导致Guillain-Mollaret三角的任何组成部分中断引起的。在这项工作中，我们描述了齿状核和中央被盖束病变的病例。交叉性小脑性共济失调在其急性期和慢性期呈现出特定的影像学表现和临床相关性。脑桥小脑束的纤维损伤说明了小脑中脚的华勒氏变性。还描述了丘脑急性病变（腹外侧核）导致的齿状核T2高信号。这里描述的每种情况都有MRI图像记录，并伴有教学要点和对相关通路的解剖学回顾。
神经科医生和放射科医生需要熟悉这些疾病的诊断，因为它们的表现独特且往往很微妙，很容易被误诊为缺血性事件、退行性疾病、脱髓鞘疾病甚至肿瘤。
