烟雾病合并脑梗死继发沃勒变性1例OA

The secondary degeneration of pyramidal tract fibers after cerebral infarction is correlated with the restoration of neurological functionality.A comprehensive review of the existing literature reveals,there have been an absence of documented cases reporting with bilateral long segment neuronal degeneration secondary to bilateral minor infarcts.This case involved a youthful patient who was sought medical intervention for symptoms characterized by"weakness in the right lower limb for over six months,aggravated and slurred speech for more than a month",and had a prior medical history of hyperthyroidism.The patient was treated for several times due to exacerbation of symptoms and the occurrence of new infarctions.Cranial MRI utilizing diffusion-weighted imaging(DWI)and fluid-attenuated inversion recovery(FLAIR)sequences revealed symmetrical hyperintensity in the centrum semiovale,the posterior limb of the internal capsule,and the cerebral peduncle.The cerebral magnetic resonance angiography(MRA)of this patient indicates moyamoya disease.The symptoms were considered to bilateral corticospinal tract Wallerian degeneration,which showed significant improvement following cognitive enhancement therapy and standard treatment for cerebral infarction.This case report highlights the importance of secondary prevention in patients with small infarcts complicated with moyamoya disease,emphasizing the need for vigilance against recurrent infarction and deterioration of primary symptoms.Such patients are more prone to develop Wallerian degeration.This findings of this study may serve as a reference for clinical diagnosis and treatment of similar cases.