Prognosis and MRI after ischemic stroke of the basal ganglia

Pediatr Neurol. 1992 Mar-Apr;8(2):104-8. doi: 10.1016/0887-8994(92)90029-x.

Abstract

The clinical courses and long-term prognoses in 16 young patients with infarctions of the basal ganglia were evaluated and the recent magnetic resonance imaging findings in 9 of them were examined. Only 5 of 14 patients (35%) had motor sequelae, 4 had hemiparesis, and 1 had gait disturbance. Secondary dystonia occurred in 1 patient. Magnetic resonance imaging disclosed a circumscribed lesion in the basal ganglia, as reflected by T2 high- and T1 low-intensity signals, in all patients. The abnormal region on T2-weighted images usually was more extensive than that observed on T1-weighted ones. The hemiplegic patients each had an area of abnormal intensity in the internal capsule or corona radiata with relatively high signals on the T2- and proton-density-weighted images. Mild to moderate asymmetric atrophy of the midbrain on the side ipsilateral to the stroke lesion was observed in 8 of 9 patients. The mechanism involved may be remote transsynaptic neuronal death of the substantia nigra, as well as Wallerian degeneration of the pyramidal tract.

MeSH terms

  • Adolescent
  • Adult
  • Basal Ganglia Diseases / diagnosis*
  • Basal Ganglia Diseases / physiopathology
  • Brain Damage, Chronic / diagnosis
  • Brain Damage, Chronic / physiopathology
  • Cerebral Infarction / diagnosis*
  • Cerebral Infarction / physiopathology
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Neurologic Examination*
  • Prognosis
  • Pyramidal Tracts / physiopathology