Analyzing The Pathogenies Of Patiens With Symmetric Imaging Lesions Of The Deep Gray Nuclei

Objective: To discuss the causes of symmetric lesions of subcortical gray matter nuclei with clinical manifestation from neuroimaging study, and to improve the diagnosis ability.Method: To Study symmetric lesions of subcortical gray matter nuclei (71 cases) diagnosed by CT or MRI in our hospital or by consultation from 2003 Jan. to 2007 Sep. and to make an analysis and comparison with history,clinical manifestation and features of neuroimaging.Result: Genetic diseases (20 cases) were the most common, , including Kinnier-Wilson syndrome (16 cases), Huntington disease (2 cases), essential tremor (1 case), and Fahr disease (1 case, including seven people of three generations from the same family). The second one was toxic diseases (16 cases), including of carbon monoxide (CO) intoxation (7 cases) which was the most common among them, chronic manganism (4 cases), heroin spongiform leukoencephalopathy (HSLE) (1 case), organophosphorus pesticide (3 cases) and unknown material intoxation (1 case). The third was metabolic diseases (13 cases), including hypoparathyroidism (8 cases), Wernicke encephalopathy (4 cases), central pontine myelinolysis (1 case) which due to too rapid correction of hyponatremia, and chronic hepatic encephalopathy (1 case). The forth was hypoxicischaemic diseases (10 cases), including hypovolemic shock (5 cases), diseases appeared after cardiopulmonary resuscitation (2 cases), hypoxemia (2 cases), and Hann's syndrome (1 case). The fifth was vascular diseases(5 cases), most of them were ischemic cerebrovascular diseases, including 4 cases of top of the basilar syndrome and one case of neonatal apoplexy. There were 2 cases of cephalitis involving thalamus and 1 case of central nervous system lymphoma. There were 2 cases with unknown reason. One of them had extracorticospinal tract symptom and changes on MRI: hyperintensity on T1WI, hyperintensity on T2WI of globus pallidus. The other appeared numbness and tremor and showed isointensity on T1WI and hyperintensity on T2WI.Conclusion: 1. The cause of symmetric lesion of subcortical gray matternuclei from neuroimaging could be genetic, toxic, metabolic, hypoxicischemic,vascular and other rare reasons. But the genetic disease is the most common one.2.Different manifestation on cranium computed tomography and magneticresonance imaging make a importen role on the diacrisis of pathogeny.3. Different diseases usually damage different gray nucle in the basal ganglia, therefore, location of affection can help us find the resean that cause symmetric lesions of subcortical gray matter nuclei.4. It is important to analyze the clinical manifestation especially case history and laboratory examination with characteristic of neuroimaging, for diagnosing the causes of symmetric lesions of subcortical gray matter nuclei.