Wallerian degeneration

Case contributed by Dr Amr Farouk

Presentation

Hypertensive patient with history of stroke 8 years ago

Patient Data

Age: 45 years
Gender: Female
MRI

Reduced volume of the left cerebral hemisphere namely temporal parietal and occipital regions with peri-ventricular patchy areas of high T2 signal intensities and irregularly shaped areas of CSF like signal being of cortical and subcortical location. Associated passive dilatation of the left lateral ventricle is seen. Reduced volume of the left side of the brain stem.

Case Discussion

Left cerebral hemisphere temporal parietal and occipital regions encephalomalacia/gliosis. Associated with reduced volume of the left side of the brain stem with no altered MR signal representing atrophy of the white matter tracts which occur months to years following cerebral infarction compatible with stage IV Wallerian degeneration.

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