Diffusion weighted imaging in ataxic hemiparesis

Abstract

Objective: Ataxic hemiparesis (AH) is a well recognised lacunar syndrome involving homolateral ataxia with accompanying corticospinal tract impairment. Most previous studies of lesion location in AH did not use diffusion weighted MRI (DW MRI). The purpose of this study was to use DW MRI to evaluate the radiological correlation in patients presenting with AH. Methods: Retrospectively, we studied 29 patients with AH using DW MRI. Results: All patients were scanned within 4 days of onset. Acute infarction was identified in 28 of 29 (97%) patients. A single lesion was identified in 26 patients: pons (n = 8), internal capsule (n = 6), corona radiata (n = 2), distended internal capsule from corona radiate (n = 7), frontal subcortical area (n = 1) and precentral with or without postcentral gyrus (n = 2). Two lesions were found in two patients: in the pons and corpus callosum of one patient, and in the corona radiata and subcortical white matter of the other. Conclusions: AH is mainly caused by pontine or internal capsule/corona radiata lesions. It also occurs in the precentral gyrus, including the precentral knob, with or without postcentral gyrus lesions. Fibres of the fronto-ponto-cerebellar system may originate from the frontal cortex, including the precentral gyrus, probably near the pyramidal tract. Damage at this location may cause AH.

Ataxic Hemiparesis Associated with Cortical Infarct Localized in the Postcentral Gyrus

“…The present report details the case of an 82-year-old man with AH associated with a cortical infarct localized to the postcentral gyrus. Although some reports suggest that lesions of the precentral gyrus and frontal white matter can produce AH ( 5 , 6 ), AH associated with cortical infarction (rather than deep infarction) is rare. To our knowledge, the present report is the first to discuss AH associated with localized lesions of the postcentral gyrus.…”

“…CCD is thought to result from damage to the corticopontocerebellar and/or dentatorubral-thalamocortical pathways in patients with AH. While lesions in the cerebral cortex may also be implicated in the pathogenesis of AH, such occurrences are rare, and the details regarding the role of cortical damage in producing symptoms of AH as well as its association with CCD remain to be elucidated ( 5 ). The current report details a case of AH resulting from acute infarction associated with localized lesions of the postcentral gyrus in a patient without CCD.…”

Cerebrocerebellar System and Türck's Bundle

“…The designation Türck's bundle remained in the literature for a long time to designate the posterior cortical projections to the pons and can be found even in recent papers (Bogousslavsky et al, 1986;Hiraga, Uzawa, & Kamitsukasa, 2007).…”

Globular glial tauopathy Type I presenting with behavioral variant frontotemporal dementia

“…These anatomical networks might explain the weakness and incoordination of the motor function. 24,25 GGT classification based on biochemistry…”