Assessment of bilateral cerebral peduncular infarction: Magnetic resonance imaging, clinical features, and prognosis

Chen, Wenhuo; Yi, Tingyu; Chen, Yuehong; Zhang, Meifang; Wu, Zong-Zhong; Wu, Yanmin; Chen, Bailing; Guo, Tao; Wu, Chao-xin; Yang, Miao-xiong; Chen, Xuejiao; Shi, Yan‐Chuan

doi:10.1016/j.jns.2015.07.016

Cited by 14 publications

(18 citation statements)

References 17 publications

(21 reference statements)

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“…We suppose that occlusion of both VA or proximal BA may lead to hypoperfusion in the watershed area between the AICA and the superior cerebellar arteries, resulting in infarction in the BMCPs. Similar to the bilateral cerebral peduncular infarction [16], a hypoperfusion mechanism was also found in patients with BMCPI. Interestingly, Au et al [17] reported a typical BMCPI patient who was diagnosed as cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy.…”

Section: Discussionmentioning

confidence: 60%

Evaluation of Clinical Features and Stroke Etiology in Patients with Bilateral Middle Cerebellar Peduncle Infarction

et al. 2020

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The aim of this study was to characterize clinical features, etiologies, and mechanisms of strokes due to bilateral middle cerebellar peduncle infarction (BMCPI). Methods: Cases diagnosed as BMCPI in our hospital were retrieved, and a literature review was performed. Data on clinical features and brain MRI were obtained. Extracranial and intracranial segments of the vertebrobasilar artery were assessed by using digital subtraction angiography, magnetic resonance angiography, or computed tomography angiography. Results: Thirteen cases (11 men and 2 women) of BMCPI were identified. A high-intensity signal of diffusionweighted imaging sequence involving the bilateral middle cerebellar peduncle was observed in all patients. Most patients experienced vertigo, dysarthria, ataxia, and hearing disorders. Eleven of these cases were classified as large artery atherosclerosis, one as traumatic vertebral artery (VA) dissection, and one as giant cell arteritis. Conclusion: BMCPI is a rare cerebrovascular disease characterized by vertigo, ataxia, and dysarthria, which may also be accompanied by a hearing deficit or clinical signs of brainstem damage. BMCPI may be associated with hypoperfusion secondary to occlusive disease of the bilateral VA or proximal basilar artery.

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Section: Discussionmentioning

confidence: 60%

Evaluation of Clinical Features and Stroke Etiology in Patients with Bilateral Middle Cerebellar Peduncle Infarction

et al. 2020

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“…The causes and risk factors of BCPI are the same as those of posterior circulation cerebral infarction, and atherosclerosis is the most common cause of BCPI (9) while hypertension, diabetes mellitus, hyperlipidemia, coronary heart disease, and smoking are other common risk factors. According to TOAST classification (10), all of our patients were classified as having large-artery atherosclerosis (LAA), and the main mechanism of BCPI induced by LAA is hypo-perfusion (11).…”

Section: Discussionmentioning

confidence: 99%

An Analysis of Clinical Characteristics of Rare Bilateral Cerebral Peduncular Infarction

Chen

Raza

et al. 2019

Front. Neurol.

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Objective: To investigate the anatomical characteristics, clinical manifestations, and imaging features of bilateral cerebral peduncular infarction.Methods: A retrospective analysis was performed on 11 patients diagnosed with bilateral cerebral peduncular infarction in the Affiliated Hospital of Xuzhou Medical University from December 2014 to December 2018. Their clinical and imaging features were analyzed and summarized in combination with the relevant national and international literature.Results: Among all the patients, there were eight cases with a history of hypertension, four cases with a history of diabetes mellitus, and four cases with a history of smoking. Conscious disturbance was observed in nine cases, quadriplegia in seven cases, pseudobulbar paralysis in three cases, and ataxia in one case. Brain magnetic resonance (MR) scans of bilateral cerebral peduncles showed patchy abnormal shadows with a hypointense signal on T1-weighted imaging (T1WI) and apparent diffusion coefficient (ADC) and hyperintense signal on T2-weighted imaging (T2WI), fluid-attenuated inversion recovery (FLAIR), and diffusion-weighted imaging (DWI). Computed tomography angiography (CTA) scans of head and neck showed severe stenosis or occlusion of vertebral artery, basilar artery, or posterior cerebral artery. All the patients received standardized treatment for cerebral infarction. Six patients died while five were left disabled.Conclusion: Bilateral cerebral peduncle infarction may be related to cerebral perfusion insufficiency caused by the stenosis or occlusion of vertebrobasilar artery and its branches. The main clinical manifestations are locked-in syndrome and persistent vegetative state. The specific imaging feature of “Mickey Mouse ear”-like infarction is associated with a poor prognosis.

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“…11 patients were diagnosed with large artery atherosclerosis (LAA), 1 was diagnosed with artery-to-artery embolism, and the other 2 were diagnosed with cardiac embolism. The main mechanism of BCPI caused by LAA was hypoperfusion in their study [ 1 ]. In our patient, both basilar artery and the bilateral PCA were not shown on the MRA due to the severe decrease in the flow signals.…”

Section: Discussionmentioning

confidence: 99%

“…Bilateral cerebral peduncular infarctions (BCPI) are an extremely rare neurological disorder, occurring in only 0.26% of patients with acute ischemic stroke [ 1 ]. The anatomic etiology is presumed to be the occlusion or stenosis of the large vertebrobasilar artery.…”

Section: Introductionmentioning

confidence: 99%

A Case Report of Isolated Bilateral Cerebral Peduncular Infarction

Zhou

Tian

et al. 2017

Case Reports in Neurological Medicine

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Isolated bilateral cerebral peduncular infarctions (BCPI) presenting as acute pseudobulbar palsy are rarely reported and, to the best of our knowledge, most of the previous reports of BCPI were related to locked-in syndrome and disturbance of consciousness. Herein, we described a case of a 55-year-old man who presented with acute pseudobulbar palsy and mild tetraparesis, but preserved eye movements, with no consciousness disturbance. DWI revealed an acute infarction involving the central portion of the cerebral peduncle with a characteristic “traditional Chinese eight character” sign. The relationship between the infarcted range in the cerebral peduncle and the clinical manifestation was discussed in our report.

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Assessment of bilateral cerebral peduncular infarction: Magnetic resonance imaging, clinical features, and prognosis

Cited by 14 publications

References 17 publications

Evaluation of Clinical Features and Stroke Etiology in Patients with Bilateral Middle Cerebellar Peduncle Infarction

Evaluation of Clinical Features and Stroke Etiology in Patients with Bilateral Middle Cerebellar Peduncle Infarction

An Analysis of Clinical Characteristics of Rare Bilateral Cerebral Peduncular Infarction

A Case Report of Isolated Bilateral Cerebral Peduncular Infarction

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