A demonstration of Wallerian degeneration of the descending tract in the brain stem by means of computed tomography

It is well known that atrophic changes in the ipsilateral brain stem due to the Wallerian degeneration of the corticospinal (pyramidal) tract are accompanied by a cerebrovascular disease (CVD). In this study, Wallerian degeneration as focal low densities instead of an atrophy of the ipsilateral descending tract of the brain stem is demonstrated by means of computed tomography (CT) in 7 out of 210 patients within 6 months after the onset of the CVD. In one case of an occlusion of the left middle cerebral artery, CT could demonstrate the ipsilateral focal low densities in the cerebral peduncle and pontine base 1 month after the onset. Patients with Wallerian degeneration demonstrated by CT had hemiparalysis. The outcomes were fair, or if there was bilateral impairment, it was vegetative. CT is important and useful in diagnosing both the Wallerian degeneration of the descending tract in the brain stem and the physiological prognosis of the patients with CVD. (author)