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Changes in a cerebellar peduncle lesion in a patient with Dandy-Walker malformation A diffusion tensor imaging study

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Neural Regeneration Research 2013年第5期8卷 474-478页

作者： Ah Young lee Sung Ho Jang Sang Seok Yeo ensil lee Yun Woo Cho Su Min Son Department of Physical Medicine and Rehabilitation College of Medicine Yeungnam University Department of Pediatrics College of Medicine Yeungnam University

We report a patient with severe ataxia due to Dandy-Walker malformation, who showed functional recovery over 10 months corresponding to a change in a cerebellar peduncle lesion. A 20-month-old female patient who was diagnosed with Dandy-Walker syndrome and six age- and sex-matched healthy control subjects were enrolled. The superior cerebellar peduncle, the middle cerebellar peduncle, and the inferior cerebellar peduncle were evaluated using fractional anisotropy and the apparent diffusion coefficient. The patients＇ functional ambulation category was 0 at the initial visit, but improved to 2 at the follow-up evaluation, and Berg＇s balance scale score also improved from 0 to 7. Initial diffusion tensor tractography revealed that the inferior cerebellar peduncle was not detected, that the fractional anisotropy of the superior cerebellar peduncle and middle cerebellar peduncle decreased by two standard deviations below, and that the apparent diffusion coefficient increased by two standard deviations over normal control values. However, on follow-up diffusion tensor tractography, both inferior cerebellar peduncles could be detected, and the fractional anisotropy of superior cerebellar peduncle increased to within two standard deviations of normal controls. The functional improvement in this patient appeared to correspond to changes in these cerebellar peduncles. We believe that evaluating cerebellar peduncles using diffusion tensor imaging is useful in cases when a cerebellar peduncle lesion is suspected.

关键词： neural regeneration neuroimaging Dandy-Walker malformation cerebellar peduncle ataxia cerebral palsy functional ambulation category Berg's balance scale fractional anisotropy apparent diffusion coefficient diffusion tensor tractography diffusion tensor imaging grants-supported paper photographs-containing paper neuroregeneration

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