Secondary pallidonigral degeneration mimicking recurrent acute stroke in clinical presentation and magnetic resonance imaging: A case report

Research output: Contribution to journalArticle

Abstract

Background: Secondary pallidonigral transneuronal degeneration after a remote primary cerebral infarct can mimic recurrent stroke at clinical presentation. We describe a patient with secondary pallidonigral degeneration following a previous putaminal infarct, which was diagnosed through diffusion-weighted (DWI) and T2-weighted imaging (T2WI). Case presentation: A 64-year-old man complained of an acute relapse of right-lower-limb weakness following a cerebral infarction 2 months before presentation. Recurrent cerebral stroke was initially diagnosed in the emergency room. DWI of the brain revealed a subacute to chronic infarct in the left putamen and new acute cytotoxic edema in the left substantia nigra (SN) and globus pallidus while T2WI also showed hyperintensity in the same regions. The SN was outside the aforementioned middle cerebral arterial territory, which includes the putamen. These findings are compatible with the diagnosis of acute pallidonigral injury secondary to striatal infarction. The patient had fully recovered from his right-lower-limb weakness after 1 month. Conclusions: Secondary pallidonigral degeneration may mimic recurrent stroke. DWI along with T2WI facilitates elucidation of this clinicopathological entity, and thus unnecessary treatment can be avoided.

Original languageEnglish
Article number215
JournalBMC Neurology
Volume17
Issue number1
DOIs
Publication statusPublished - Dec 11 2017

Fingerprint

Putamen
Stroke
Magnetic Resonance Imaging
Substantia Nigra
Lower Extremity
Corpus Striatum
Globus Pallidus
Cerebral Infarction
Infarction
Hospital Emergency Service
Edema
Recurrence
Wounds and Injuries
Brain
Therapeutics

Keywords

  • Diffusion-weighted imaging
  • Pallidonigral degeneration
  • Recurrent stroke

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

@article{7bc9c759b3794e1da55a474e989a4e37,
title = "Secondary pallidonigral degeneration mimicking recurrent acute stroke in clinical presentation and magnetic resonance imaging: A case report",
abstract = "Background: Secondary pallidonigral transneuronal degeneration after a remote primary cerebral infarct can mimic recurrent stroke at clinical presentation. We describe a patient with secondary pallidonigral degeneration following a previous putaminal infarct, which was diagnosed through diffusion-weighted (DWI) and T2-weighted imaging (T2WI). Case presentation: A 64-year-old man complained of an acute relapse of right-lower-limb weakness following a cerebral infarction 2 months before presentation. Recurrent cerebral stroke was initially diagnosed in the emergency room. DWI of the brain revealed a subacute to chronic infarct in the left putamen and new acute cytotoxic edema in the left substantia nigra (SN) and globus pallidus while T2WI also showed hyperintensity in the same regions. The SN was outside the aforementioned middle cerebral arterial territory, which includes the putamen. These findings are compatible with the diagnosis of acute pallidonigral injury secondary to striatal infarction. The patient had fully recovered from his right-lower-limb weakness after 1 month. Conclusions: Secondary pallidonigral degeneration may mimic recurrent stroke. DWI along with T2WI facilitates elucidation of this clinicopathological entity, and thus unnecessary treatment can be avoided.",
keywords = "Diffusion-weighted imaging, Pallidonigral degeneration, Recurrent stroke",
author = "Tsai, {Ruei Je} and Hsieh, {Li Chun} and Cheng, {Sho Jen} and Chen, {Cheng Yu}",
year = "2017",
month = "12",
day = "11",
doi = "10.1186/s12883-017-1000-5",
language = "English",
volume = "17",
journal = "BMC Neurology",
issn = "1471-2377",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Secondary pallidonigral degeneration mimicking recurrent acute stroke in clinical presentation and magnetic resonance imaging

T2 - A case report

AU - Tsai, Ruei Je

AU - Hsieh, Li Chun

AU - Cheng, Sho Jen

AU - Chen, Cheng Yu

PY - 2017/12/11

Y1 - 2017/12/11

N2 - Background: Secondary pallidonigral transneuronal degeneration after a remote primary cerebral infarct can mimic recurrent stroke at clinical presentation. We describe a patient with secondary pallidonigral degeneration following a previous putaminal infarct, which was diagnosed through diffusion-weighted (DWI) and T2-weighted imaging (T2WI). Case presentation: A 64-year-old man complained of an acute relapse of right-lower-limb weakness following a cerebral infarction 2 months before presentation. Recurrent cerebral stroke was initially diagnosed in the emergency room. DWI of the brain revealed a subacute to chronic infarct in the left putamen and new acute cytotoxic edema in the left substantia nigra (SN) and globus pallidus while T2WI also showed hyperintensity in the same regions. The SN was outside the aforementioned middle cerebral arterial territory, which includes the putamen. These findings are compatible with the diagnosis of acute pallidonigral injury secondary to striatal infarction. The patient had fully recovered from his right-lower-limb weakness after 1 month. Conclusions: Secondary pallidonigral degeneration may mimic recurrent stroke. DWI along with T2WI facilitates elucidation of this clinicopathological entity, and thus unnecessary treatment can be avoided.

AB - Background: Secondary pallidonigral transneuronal degeneration after a remote primary cerebral infarct can mimic recurrent stroke at clinical presentation. We describe a patient with secondary pallidonigral degeneration following a previous putaminal infarct, which was diagnosed through diffusion-weighted (DWI) and T2-weighted imaging (T2WI). Case presentation: A 64-year-old man complained of an acute relapse of right-lower-limb weakness following a cerebral infarction 2 months before presentation. Recurrent cerebral stroke was initially diagnosed in the emergency room. DWI of the brain revealed a subacute to chronic infarct in the left putamen and new acute cytotoxic edema in the left substantia nigra (SN) and globus pallidus while T2WI also showed hyperintensity in the same regions. The SN was outside the aforementioned middle cerebral arterial territory, which includes the putamen. These findings are compatible with the diagnosis of acute pallidonigral injury secondary to striatal infarction. The patient had fully recovered from his right-lower-limb weakness after 1 month. Conclusions: Secondary pallidonigral degeneration may mimic recurrent stroke. DWI along with T2WI facilitates elucidation of this clinicopathological entity, and thus unnecessary treatment can be avoided.

KW - Diffusion-weighted imaging

KW - Pallidonigral degeneration

KW - Recurrent stroke

UR - http://www.scopus.com/inward/record.url?scp=85037714874&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85037714874&partnerID=8YFLogxK

U2 - 10.1186/s12883-017-1000-5

DO - 10.1186/s12883-017-1000-5

M3 - Article

AN - SCOPUS:85037714874

VL - 17

JO - BMC Neurology

JF - BMC Neurology

SN - 1471-2377

IS - 1

M1 - 215

ER -