Learning objectives
To evaluate the normal and abnormal findings of the deep grey matter structures in CT and MR imaging.
To review the wide spectrum of differential diagnosis of bilateral basal ganglia and thalamus pathology.
Background
A.
ANATOMY / FUNCTION
Basal ganglia refer to the paired deep grey matter nuclei located,
consisting of:
caudate nucleus
putamen
globus pallidus
nucleus accumbens
olfactory tubercle
From a functional standpoint,
many authors consider the substantia nigra and subthalamic nucleusas part of the basal ganglia.
The caudate nucleus,
putamen and globus pallidus compose the corpus striatum,
while the putamen along with the globus pallidus form the lentiform nucleus.
The basal ganglia are widely connected with the cerebral cortex,
thalami and brainstem and constitute the arena of...
Findings and procedure details
We present our single-centre experience,
with patients admitted to our Emergency department,
initially evaluated with CT imaging using a 16-slice scanner.
Inmost cases CT imaging was negative and MRI with a 1.5T scanner complemented further investigation.
We display a series of illustrative cases with bilateral basal ganglia and thalamus pathology.
1) Infarct
Arterial infarction of both thalami may appeardue to occlusion of the rostral basilar artery.
Clinical presentation includes memoryand sensory disorders,
sleep-wake cycle impairment,
neuropsychological abnormalities or alteration of consciousnessor even coma.
On MRI,...
Conclusion
Bilateral abnormalities of the deep grey matter nuclei on CT or MR imaging usually trigger the need for an in-depth investigation based on the patient’s clinical history and laboratory features.
The radiological findings in most cases can help pinpoint the most probable differential diagnoses or even lead to the correct diagnosis.
References
1.
José L.
Lanciego,
Natasha Luquin,
José A.
Obeso.
Functional Neuroanatomy of the Basal Ganglia.
Cold Spring Harb Perspect Med.
2012 Dec; 2(12): a009621.
2.
Ring HA,
Serra-Mestres J.
Neuropsychiatry of the basal ganglia.
Journal of Neurology,
Neurosurgery & Psychiatry 2002;72:12-21.
3.
Chen,
X.Y.,
Wang,
Q.,
Wang,
X.
et al.
Clinical Features of Thalamic Stroke.
Curr Treat Options Neurol 2017; 19: 5.
4.
Amogh N.
Hegde,
MD,
Suyash Mohan,
MD,
Narayan Lath,
MD,
C.
C.
Tchoyoson Lim.
Differential Diagnosis for Bilateral Abnormalities of the Basal...