Waragai M, Iwbuchi S
Department of Neurology Stroke Center, Nanasawa Rehabilitation Hospital.
Rinsho Shinkeigaku. 1993 Nov;33(11):1146-53.
We studied Wallerian degeneration of the cortico-descending tract in the cerebral peduncle following a supratentorial cerebrovascular lesion by MRI. A total of 57 patients with palsy following a supratentorial cerebrovascular lesion were prospectively studied. Wallerian degeneration was detected as a high signal intensity (HSI) in 37 patients between 70 days and 100 days after the onset, but not detected in the remaining 27 patients. Patient with an HSI in all area of the cerebral peduncle had a large lesion involving the hemisphere. Patient with an HSI at the center of the cerebral peduncle had a lesion confined to the paracentral gyrus, precentral gyrus, corona radiata or posterior limb of the internal capsule. Patient with an HSI at the lateral side of the cerebral peduncle had a lesion of parietal lobe or temporal lobe which spares the corticospinal tract originating from the paracentral gyrus, precentral gyrus, corona radiata or posterior limb of the internal capsule. These findings suggest that an HSI at the center of the cerebral peduncle may reveal Wallerian degeneration of the corticospinal tract, and an HSI at the lateral side of the cerebral peduncle may show Wallerian degeneration of the corticopontine tract. The functional recovery of paresis was poor in all patients with an HSI at the center of the cerebral peduncle, while it was good in all patients without an HSI in that region.(ABSTRACT TRUNCATED AT 250 WORDS)
我们通过磁共振成像（MRI）研究了幕上脑血管病变后大脑脚皮质下行束的华勒氏变性。前瞻性地研究了总共57例幕上脑血管病变后出现麻痹的患者。在发病后70天至100天之间，37例患者检测到华勒氏变性表现为高信号强度（HSI），而其余27例患者未检测到。大脑脚所有区域出现HSI的患者有涉及半球的大病变。大脑脚中央出现HSI的患者病变局限于中央旁回、中央前回、放射冠或内囊后肢。大脑脚外侧出现HSI的患者有顶叶或颞叶病变，不累及源自中央旁回、中央前回、放射冠或内囊后肢的皮质脊髓束。这些发现表明，大脑脚中央的HSI可能揭示皮质脊髓束的华勒氏变性，而大脑脚外侧的HSI可能显示皮质脑桥束的华勒氏变性。大脑脚中央出现HSI的所有患者麻痹功能恢复较差，而该区域未出现HSI的所有患者功能恢复良好。（摘要截短至250字）
