An Investigation To The Secondary Degeneration Of Substantial Nigra After Striatum Infarct With Magnetic Resonance Imaging

Objective: To understand the MRI positive rate of the patients who had secondary degeneration of substantial nigra after striatum infartion.To explore and summarize the MRI characteristic in order to distinguish with the substantia nigral primary sections.To evaluate whether the substantia nigral secondary degeneration which had been detected with MRI can have an effect on patients'neural funtion recovery.Method: Retrospectively collect and analysise the clinical data and head MRI data of in-patients from January 2008 to September 2010 at the first afflicated hospital of Guangxi Medical University, who should follow these consitions:1) the first onset ,2)unilateral movement function impaired, aphasia,central facial and tongue paralysis or hypoaesthesia,3) unilateral basal ganglia exist single infarction confirmed by MRI, including ipsilateral striatum.Then analyse these data and summarize the the MRI characteristic and the clinical significance.Results:70 patients were collected, and 27 of them demonstrated the secondary impairment of substantial nigra after striatum infarction. the MRI positive rate of whom was 38.57%,17 were male and 10 were female ,from 30 to 82 years old, with average age of 54.78±14.47 years. Most of them had one or more cerebral infarction risk factors such as hypertension,hyperlipoidemia and diabetes mellitus and so on. The earliest detection time of ipsilateral substantia nigra peformed high intensity on T₂WI was the 6th day after cerebral infarction . The signal change could recover gradually even disappear after 3 months. Patients occured secondary impairment whose NIHSS of acute phase and subacute phase were 10.89±5.97,8.67±5.97. Among the 27 patients two cases appeared symptoms which were similar with Parkinson's disease ..Conclusion: About 38.57% of the 70 patients'MRI data could show signal change on the ipsilateral substantia nigra, which performed the high intensity change on T₂WI and FLAIR during acute or subacute and could recover gradually even disappear after 3 months.,while there was no obvious signal change on T₁WI. It could be recognize the secondary degeneration of substantia nigra after striatal infarction with MRI ,instead of new infarction or others.The secondary degeneration might result in vascular parkinsonism.