Striatal Infarction Elicits Secondary Extrafocal MRI Changes in Ipsilateral Substantia Nigra

PloS One
Benjamin WinterMatthias Endres

Abstract

Focal ischemia may induce pathological alterations in brain areas distant from the primary lesion. In animal models, exofocal neuron death in the ipsilateral midbrain has been described after occlusion of the middle cerebral artery (MCA). Using sequential magnetic resonance imaging (T2- and diffusion-weighted) at 3 Tesla, we investigated acute ischemic stroke patients on days 1, 2, 6, 8, and 10 after stroke onset. Sixteen consecutive patients who had suffered a stroke involving the caudate nucleus and/or putamen of either hemisphere were recruited into the study. Four additional patients with strokes sparing the caudate nucleus and putamen but encompassing at least one-third of the MCA territory served as controls. Ischemic lesions involving striatal structures resulted in hyperintense lesions in ipsilateral midbrain that emerged between days 6 and 10 after stroke and were not present on the initial scans. In contrast, none of the control stroke patients developed secondary midbrain lesions. Hyperintense lesions in the pyramidal tract or the brain stem caused by degeneration of the corticospinal tract could be clearly distinguished from these secondary midbrain gray matter lesions and were detectable from day 2 after ischemia. ...Continue Reading

References

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Citations

Nov 1, 2016·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Pavel YanevRick M Dijkhuizen
Jun 28, 2016·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Lin Kooi OngMichael Nilsson
Dec 21, 2018·Stroke; a Journal of Cerebral Circulation·D Leander RimmeleGötz Thomalla
Apr 25, 2020·Journal of Neural Transmission·Carlos Eduardo Mantese, Tulio Becker Hainzenreder
Feb 17, 2017·Journal of the American Heart Association·Johannes KaesmacherJustus F Kleine

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Clinical Trials Mentioned

NCT00715533

Software Mentioned

SPM8
MRIcro
THAT
MATLAB
1000Plus

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