目的:脑桥梗死后小脑中段(MCPs)的华勒变性(WD)是一种罕见的继发性退行性神经系统疾病。由于其频率不高,对其特征的研究有限。
方法:本研究旨在介绍3例脑桥梗死后MCPs的WD,并分析其预后。临床表现,通过将我们的病例与以前报道的病例合并,以及神经影像学特征。
结果:队列包括25例,包括18名男性和7名女性,年龄在29至77岁之间(平均年龄:66.2岁)。大多数患者(94%)表现出脑血管疾病的危险因素,高血压是主要的危险因素。磁共振成像(MRI)可以在脑桥梗死后21天至12个月的范围内检测MCP的WD。这种变性的特征是MCP中T2/FLAIR加权图像(WI)病变上的双侧对称高强度。此外,限制扩散,弥散加权成像(DWI)强度高,表观弥散系数(ADC)低的信号强度最早可在梗死后21天观察到.在检测到WD时,据观察,有20名患者(80%)在随后的临床就诊中保持无症状,而4人(16%)经历了先前存在的症状恶化。
结论:这些发现强调了神经科医生通过获得对神经影像学特征的新见解来增强对这种情况的理解的重要性。临床表现,双侧MCPsWD患者的预后。
OBJECTIVE: Wallerian degeneration (WD) of the middle cerebellar peduncles (MCPs) following pontine infarction is a rare secondary degenerative neurological condition. Due to its infrequency, there is limited research on its characteristics.
METHODS: This study aims to present three cases of WD of MCPs following pontine infarction and to analyze the prognosis, clinical manifestations, and neuroimaging features by amalgamating our cases with previously reported ones.
RESULTS: The cohort consisted of 25 cases, comprising 18 men and 7 women aged 29 to 77 years (mean age: 66.2 years). The majority of patients (94%) exhibit risk factors for cerebrovascular disease, with hypertension being the primary risk factor. Magnetic resonance imaging (MRI) can detect WD of MCPs within a range of 21 days to 12 months following pontine infarction. This degeneration is characterized by bilateral symmetric hyperintensities on T2/FLAIR-weighted images (WI) lesions in the MCPs. Moreover, restricted diffusion, with hyperintensity on diffusion-weighted imaging (DWI) and low apparent diffusion coefficient (ADC) signal intensity may be observed as early as 21 days after the infarction. Upon detection of WD, it was observed that 20 patients (80%) remained asymptomatic during subsequent clinic visits, while four (16%) experienced a worsening of pre-existing symptoms.
CONCLUSIONS: These findings underscore the importance of neurologists enhancing their understanding of this condition by gaining fresh insights into the neuroimaging characteristics, clinical manifestations, and prognosis of individuals with WD of bilateral MCPs.