J Korean Soc Radiol.  2018 Oct;79(4):242-245. 10.3348/jksr.2018.79.4.242.

Bilateral Wallerian Degeneration of the Middle Cerebellar Peduncle and Unilateral Hypertrophic Olivary Degeneration Secondary to Pontine Hemorrhage: A Case Report

• Yoon JH
• Kim S
• Choi S
• Kang M
• Cho E

• KMID: 2421229
• DOI: http://doi.org/10.3348/jksr.2018.79.4.242

Abstract

The two distinct types of axonal degeneration that occur after neuronal injury include Wallerian degeneration (WD) and transneuronal degeneration. The most commonly recognizable cause of secondary degeneration is cerebral infarction, but may also include a variety of conditions including hemorrhage, trauma, necrosis, and focal demyelination. Herein, we present a rare case of WD of the cerebellar peduncles accompanied by unilateral hypertrophic olivary degeneration following pontine hemorrhage.

MeSH Terms

Axons
Cerebral Infarction
Demyelinating Diseases
Hemorrhage*
Intracranial Hemorrhages
Middle Cerebellar Peduncle*
Necrosis
Neurons
Olivary Nucleus
Wallerian Degeneration*

Figure

• 

  Fig. 1 A 49-year-old man with Wallerian degeneration of the pontocerebellar tract and hypertrophic olivary degeneration after pontine hemorrhage. A. Axial unenhanced brain computed tomography image obtained at the time of onset shows a large pontine hemorrhage. B. FLAIR image obtained 7 months after onset shows sequelae of hemorrhage in the bilateral aspects of the central pons, which left the right central tegmental tract (arrow) relatively spared. C, D. Axial FLAIR images show a faint high signal intensity lesion bilaterally in the middle cerebellar peduncles (arrows; C). In addition, a hyperintense lesion with mild enlargement is seen in the left inferior olivary nucleus (arrowhead; D). FLAIR = fluid attenuated inversion recovery

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