» Articles » PMID: 38946709

Neuroimaging and Clinical Features of Bilateral Wallerian Degeneration of Middle Cerebellar Peduncles Subsequent to Pontine Infarction

Overview
Specialties Neurology
Pharmacology
Date 2024 Jul 1
PMID 38946709
Authors
Affiliations
Soon will be listed here.
Abstract

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.

Citing Articles

Neuroimaging and clinical features of bilateral Wallerian degeneration of middle cerebellar peduncles subsequent to pontine infarction.

Zhang Y, Wei T, Yu H, Li W, Luo W, Liu B CNS Neurosci Ther. 2024; 30(7):e14828.

PMID: 38946709 PMC: 11215464. DOI: 10.1111/cns.14828.

References
1.
Hekimoglu A, Suer Dogan I, Turan A, Oztekin M, Hekimoglu B . Bilateral Wallerian Degeneration of the Pontocerebellar Tracts. Case Rep Emerg Med. 2015; 2015:970570. PMC: 4478370. DOI: 10.1155/2015/970570. View

2.
Okamoto K, Tokiguchi S, Furusawa T, Ishikawa K, Quardery A, Shinbo S . MR features of diseases involving bilateral middle cerebellar peduncles. AJNR Am J Neuroradiol. 2003; 24(10):1946-54. PMC: 8148916. View

3.
De Simone T, Regna-Gladin C, Carriero M, Farina L, Savoiardo M . Wallerian degeneration of the pontocerebellar fibers. AJNR Am J Neuroradiol. 2005; 26(5):1062-5. PMC: 8158597. View

4.
Shen Y, Jian W, Li J, Dai T, Bao B, Nie H . Bilateral wallerian degeneration of the middle cerebellar peduncles secondary to pontine infarction: A case series. J Neurol Sci. 2018; 388:182-185. DOI: 10.1016/j.jns.2018.03.027. View

5.
Zhang Y, Wei T, Yu H, Li W, Luo W, Liu B . Neuroimaging and clinical features of bilateral Wallerian degeneration of middle cerebellar peduncles subsequent to pontine infarction. CNS Neurosci Ther. 2024; 30(7):e14828. PMC: 11215464. DOI: 10.1111/cns.14828. View