History of fever with rash 2 years prior followed by left hemiparesis
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There is a well defined area of cystic encephalomalacia in right fronto-parietal cortex consistent with a chronic infarct.
Linear hyperintense band seen tracing inferiorly from this region with loss of volume of the ipsilateral posterior limb of right internal capsule and right cerebral peduncle.
MRI depicts anterograde wallerian degeneration very well.
It is seen as a band of T1 and T2 prolongation topographically limited to the region of the involved tract.
The cerebral peduncle is the best region to assess for volume loss as the pyramidal tract fibers here traverse in an almost parallel manner.
- 1. Pujol J, Martí-vilalta JL, Junqué C et-al. Wallerian degeneration of the pyramidal tract in capsular infarction studied by magnetic resonance imaging. Stroke. 1990;21 (3): 404-9. Stroke (link) - Pubmed citation
- 2. Mark VW, Taub E, Perkins C et-al. Poststroke cerebral peduncular atrophy correlates with a measure of corticospinal tract injury in the cerebral hemisphere. AJNR Am J Neuroradiol. 2008;29 (2): 354-8. doi:10.3174/ajnr.A0811 - Pubmed citation