Work

Wallerian degeneration of the middle cerebellar peduncles secondary to pontine infarction, case report, and review of literature

Year: 2025

Type: article

Abstract: Wallerian degeneration (WD) is a process of axonal degradation that occurs downstream from a primary injury site and is often seen after strokes affecting the brainstem. This case report documents WD of the bilateral middle cerebellar peduncles (MCPs) in an 81-year-old woman following chronic left paramedian pontine infarction (PPI). An ischemic stroke affecting the pons can trigger downstream axonal degeneration, known as Wallerian degeneration, which involves the structural breakdown of axons distal to the injury site. In this patient, magnetic resonance imaging (MRI) revealed symmetrically increased T2 signal intensity in the MCPs, indicative of WD associated with a known PPI. Although uncommon, it is essential to recognize WD in this location to distinguish it from new ischemic lesions. While the WD of MCPs has not been strongly linked to specific deficits, this phenomenon advances our understanding of the secondary effects of pontine strokes (PS). Detailed documentation of such cases helps improve diagnostic accuracy and prevents misinterpretation of expected postinfarct changes in neuroimaging. This report provides a valuable example of increasing awareness of WD involving MCPs due to PPI.

Source: Radiology Case Reports

DOI: 10.1016/j.radcr.2025.04.003

Authors: Zaina Brinji, Dania G Felemban, Basem Bahakeem, Mohammed H Almatrafi

Institutions: King Abdullah Medical City, Umm al-Qura University

Language: English

Topic: Acute Ischemic Stroke Management

Subfield: Epidemiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $600