Three-dimensional MRI data sets were obtained from 12 young adult patients with congenital
spastic hemiparesis caused by unilateral periventricular white matter lesions. The
impact of these lesions on corticospinal projections to the upper and lower extremities
was assessed on reconstructed semi-coronal planes following anatomical landmarks of
somatotopic organization in the precentral gyrus and in the internal capsule: a more
anterior plane running through the hand-knob of the precentral gyrus and the anterior
portion of the posterior limb of the internal capsule representing projections to
the upper extremity, and a more posterior plane running through the top of the precentral
gyrus and the middle portion of the posterior limb of the internal capsule representing
projections to the lower extremity. In addition, the total lesion extent was determined
volumetrically, and Wallerian degeneration was assessed qualitatively in the internal
capsule and quantitatively by measuring brainstem asymmetry. We found a strong correlation
between motor dysfunction of the upper and lower limb and the lateral extent of the
periventricular lesion measured on the respective semi-coronal planes. The total lesion
volume and the degree of Wallerian degeneration correlated less strongly, both reaching
statistical significance only with motor impairment of the hand.
Key words
Hemiparesis - Pyramidal tract - Magnetic resonance imaging - Multi-planar reconstruction
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Dr. Martin Staudt
Universitäts-Kinderklinik Abteilung 3
Hoppe-Seyler-Str. 1
72076 Tübingen
Germany
Email: E-mail: martin.staudt@med.uni-tuebingen.de