Magnetic Resonance Imaging Findings in Bilateral Basal Ganglia Lesions

Abstract

Introduction: Radiologists may encounter bilaterally symmetrical abnormalities of the basal ganglia on magnetic resonance imaging (MRI), typically in the context of diffuse systemic, toxic or metabolic diseases. A systematic approach and broad knowledge of pathology causing this uncommon group of conditions would be useful. Materials and Methods: This review uses illustrative images to highlight metabolic conditions, such as Leigh’s syndrome, citrullinaemia, hypoglycaemia or carbon monoxide poisoning, as well as other causes of bilateral basal ganglia lesions such as osmotic myelinolysis, deep cerebral venous thrombosis and Creutzfeldt-Jakob disease. Results: Careful assessment of radiological findings outside the basal ganglia, such as involvement of the cortex, white matter, thalamus and pons, together with clinical correlation, may be helpful in narrowing the differential diagnosis, and directing further radiological, biochemical or genetic investigations. Recent advances in MR technology have resulted in newer techniques including diffusion-weighted (DW) MR imaging and MR spectroscopy (MRS); these may be helpful if appropriately used. Conclusions: Abnormal MRI findings in the basal ganglia should not be interpreted in isolation. A systematic approach including DW MR imaging, MRS, and a broad knowledge of diffuse systemic, toxic or metabolic diseases is helpful. Key Words: Basal ganglia, Metabolic disorders

Neuroradiology: From Diagnosis to Intervention

“…The timely reviews in this issue, rich with illustrative images, into several complex clinical problems ranging from the very young to the more elderly age groups will be useful to both radiologists and clinicians in their daily practice. [11][12][13][14] Neuroradiology with its modern armamentarium, used a timely, appropriate manner, has vital contribution in clinical medicine and can guide further appropriate clinical, laboratory or imaging investigations. With the explosion in knowledge and technology, subspecialty expertise and collaboration is required to effectively harness these advances.…”