脑卒中后华勒变性一例分析

Analysis of a case of Wallerian degeneration after stroke

目的 探讨脑卒中后华勒变性的发生过程和机制.方法 报道1例临床高度怀疑脑卒中而影像学发现双侧、对称性小脑中脚异常信号的病例的诊治过程,结合临床和解剖分析双侧小脑中脚异常信号的产生机制.结果 单侧脑桥的旁正中梗死病灶可致数月后出现双侧脑桥小脑束华勒变性,表现为头颅磁共振成像上双侧小脑中脚对称、均一的长T1、长T2、高Flair、高DWI、低ADC等信号.结论 脑卒中后华勒变性是疾病的发展过程,充分认识这一现象可以避免临床误诊误治.

Objective To study the process and mechanism underlying Wallerian degeneration of the central nervous system after stroke.Methods A case suspected of stroke with bilateral symmetrical lesions in middle cerebellar peduncles （MCPs） was described.The etiology of bilateral MCP abnormal signals on MR was analyzed according to the clinical process and neuroanatomy.Results Unilateral paramedian pontine infarction,covering the crossing area of pontocerebellar fibers, would cause bilateral secondary degeneration of MCPs,with hyperintense signals on T2-,Flair and diffusion-weighted images.Conclusions Wallerian degeneration of projecting system is a common sequel after stroke and should not be misdiagnosed as other diseases.