DÄ internationalArchive9/2022Wallerian Degeneration of the Pyramidal Tract

Clinical Snapshot

Wallerian Degeneration of the Pyramidal Tract

Dtsch Arztebl Int 2022; 119: 141. DOI: 10.3238/arztebl.m2022.0013

Forbrig, R; Danek, A

LNSLNS

A 51-year-old man suffered a cardioembolic infarct in the territory of the right middle cerebral artery, with forced head and gaze deviation to the right along with left hemineglect and hemiplegia. Subsequently, head/gaze deviation, facial motor function, and neglect had improved, while the left leg remained paralyzed. The left arm showed only minimal motor improvement. Computed tomography (CT) 255 days after the event demonstrated secondary Wallerian degeneration of the pyramidal tract (A and B, arrowheads).

Cranial computed tomography
Figure
Cranial computed tomography

Historically, detection of secondary degeneration of cerebral structures played a central role in the identification of CNS functional units on the basis of their connections. Investigation of the brain by means of routine CT or magnetic resonance (MR) imaging enables visualization of degenerating fiber tracts, but current neuroscience research has switched to MR-tractography with its much higher resolution.

Dr. med. Robert Forbrig, Prof. Dr. med. Adrian Danek, Institut für Neuroradiologie, Neurologische Klinik und Poliklinik, LMU Klinikum, Ludwig-Maximilians-Universität München, robert.forbrig@med.uni-muenchen.de

Conflict of interest statement: The authors declare that no conflict of interest exists.

Translated from the original German by David Roseveare.

Cite this as: Forbrig R, Danek A: Wallerian degeneration of the pyramidal tract. Dtsch Arztebl Int 2022; 119: 141. DOI: 10.3238/arztebl.m2022.0013

Cranial computed tomography
Figure
Cranial computed tomography