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Early, evolving Wallerian degeneration of the pyramidal tract in cerebrovascular diseases: MR study.

OBJECTIVE: The purpose of this study was to demonstrate the early features of the Wallerian degenerative process and their relationship with the severity of motor deficit. MATERIALS AND METHODS: Fourteen patients with infarction or hemorrhage of the basal ganglia were studied by MRI of the same coronal slice along the pyramidal line. RESULTS: The earliest sign of abnormal signal intensity was detected 0.7 month after the initial insult. On proton-density (PD) imaging, low signal intensity was observed on 11 (73.3%) of 15 occasions from 0.7 to 2.0 months, and abnormal signal intensity was not detected 5 (83.3%) of 6 times from 2.1 to 3.7 months. High signal intensity was revealed on 11 (78.6%) of 14 occasions after 3.8 months. The widest extent of the low-intensity signal band on PD imaging was closely related to the severity of motor deficits at > 4 months. CONCLUSION: The development of the Wallerian degenerative process was divided into four stages by MRI. We conclude that the extent of Wallerian degeneration is related to the severity of motor deficit.

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