Early abnormalities related to postinfarction Wallerian degeneration: evaluation with MR diffusion-weighted imaging

J Comput Assist Tomogr. Nov-Dec 1999;23(6):1004-7. doi: 10.1097/00004728-199911000-00034.


Purpose: Wallerian degeneration (WD) is most commonly seen after cerebral infarctions and results in persistent neurological deficits. MRI may detect changes related to WD as early as 4 weeks after the insult. We sought to determine if MR diffusion-weighted imaging (DWI) detects changes of WD during the acute period that follows a cerebral infarction.

Method: Eleven patients with cerebral infarctions underwent DWI within 72 h of the onset of symptoms. DWI was performed using a high diffusion gradient strength (B = 1,000) in a single axis and trace imaging. We reviewed all images with special attention to the signal intensity in the location of the corticospinal tracts.

Results: Ten patients harbored 11 middle cerebral artery (MCA) infarcts, and one patient had an anterior cerebral artery (ACA) infarction. Only one patient with an MCA infarct showed a subtle abnormality in the ipsilateral corticospinal tract. The patient with the ACA infarct showed an abnormality in the region of the corticopontine tract.

Conclusion: As used in this study, DWI depicted presumed early WD in only 20% of instances.

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Aged
  • Cerebral Infarction / complications*
  • Child
  • Child, Preschool
  • Echo-Planar Imaging
  • Female
  • Humans
  • Image Enhancement
  • Infant
  • Infarction, Anterior Cerebral Artery / complications
  • Infarction, Middle Cerebral Artery / complications
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Pons / pathology
  • Pyramidal Tracts / pathology
  • Retrospective Studies
  • Wallerian Degeneration / diagnosis
  • Wallerian Degeneration / etiology*