Common and uncommon neuroimaging manifestations of ataxia: an illustrated guide for the trainee radiologist. Part 1 – acquired diseases

Abstract

Ataxia is defined as a lack of coordination of voluntary movement, caused by a variety of factors. Ataxia can be classified by the age at onset and type (chronic or acute). The causative lesions involve the cerebellum and cerebellar connections. The correct, appropriate use of neuroimaging, particularly magnetic resonance imaging, can make the diagnosis relatively accurate and facilitate implementation of the appropriate clinical management. The purpose of this pictorial essay is to describe the imaging findings of ataxia, based on cases obtained from the archives of a tertiary care hospital, with a review of the most important findings. We also review and discuss the imaging aspects of infectious, toxic, vascular, and inflammatory diseases.

Benedikt syndrome in a 74‐year‐old hypertensive woman: A case report

“…Benedikt syndrome is caused by the injury of the midbrain tegmentum and manifests as a constellation of symptoms. The tegmentum encompasses the nuclei of the oculomotor (III) and trochlear (IV) cranial nerves, white matter tracts, including the decussation of superior cerebellar peduncles 9 and gray matter comprising the substantia nigra and red nucleus. 3 The oculomotor nucleus projects the third nerve, which travels near the red nucleus.…”

Keeping our balance in cerebellar ataxia: the contribution of neuroimaging to clinical investigation

“…The pictorial essays authored by Jarry et al (19,20) , published in the previous issue of Radiologia Brasileira, provide http://dx.doi.org/10.1590/0100-3984.2022.55.5e2 Editorial a valuable illustrated guide of common and uncommon neuroimaging manifestations of ataxia for radiology trainees. The authors reviewed the archives of a tertiary care hospital in Brazil and depicted acquired conditions and neurodegenerative causes of ataxia observed in this population.…”

“…Such conditions include infections (tuberculosis, cryptococcosis, and an atypical presentation of progressive multifocal leukoencephalopathy), vascular complications (stroke and venous thrombosis), inflammatory diseases (neuro-Behçet’s disease), intoxication (with phenytoin), neoplasms (Lhermitte-Duclos disease, medulloblastoma, pilocytic astrocytoma, and ependymoma), and malformations (Dandy-Walker malformation). Finally, the authors depict the characteristic imaging features of three degenerative disorders ( 19 , 20 ) : progressive ataxia and palatal tremor; Friedreich’s ataxia; and Machado-Joseph disease. By exemplifying some of the most relevant neuroimaging findings related to ataxic symptoms, these essays could help radiologists exclude acquired disorders and narrow the differential diagnosis of hereditary cerebellar ataxia.…”