Download Anatomy and Pathology of the Cerebellar Peduncle

2003 ASNR Annual Meeting Abstracts
03-SE-673-ASNR
Anatomy and Pathology of the Cerebellar
Peduncle
Author(s):
Moritani, T.·Hiwatashi, A.·Abdelhalim, A.·Ketkar, M.·Buadu, L.·DeGuzman,
R.·Wang, H.·Ekholm, S.·Westesson, P. A.
University of Rochester Medical Center
Rochester, NY.
Purpose
To illustrate the anatomy and pathology in CT and MR imaging of the cerebellar
peduncles.
Materials & Methods
We have collected over 100 cases of the cerebellar peduncle lesions, including infarction,
wallerian degeneration of the pontocerebellar tracts secondary to pontine hemorrhage or
infarction, multiple sclerosis, acute demyelinating encephalomyelitis, neurofibromatosis,
benign and malignant tumors, diffuse axonal injury, osmotic myelinolysis, crossed
cerebellar atrophy related to recurrent seizures, solvent encephalopathy, spinocerebellar
atrophy, leukoencephalopathy with vanishing white matter, and Joubert syndrome.
Results
The cerebellum is connected to the brainstem by three cerebellar peduncles: 1) the
inferior cerebellar peduncle (restiform body and juxtrarestiform body) 2) the middle
cerebellar peduncle (brachium pontis), and 3) the superior cerebellar peduncle (brachium
conjunctivum). The middle cerebellar peduncle is the largest of the three cerebellar
peduncles. It is composed mainly of axons of secondary neurons along the cortico-pontocerebellar pathway. Bilateral symmetrical rounded lesions in the middle cerebellar
peduncle can occur due to wallerian or transneuronal degeneration of this pathway. CT is
of limited use for the evaluation of the posterior fossa because of poor contrast resolution
and all the artifacts. MR imaging more clearly demonstrates the anatomy and pathology
of the cerebellar peduncle in the posterior fossa than CT. Fluid-attenuated inversion
recovery (FLAIR) images occasionally show a slight increase in signal intensity in the
normal middle cerebellar peduncles. Diffusion-weighted images clearly demonstrate
acute infarction, differentiating it from other lesions such as Wallerian degeneration and
multiple sclerosis.
Conclusion
We demonstrate CT and MR findings, including FLAIR and diffusion-weighted imaging
in patients with lesions in the cerebellar peduncles. We also illustrate the anatomy and
© 2003 ASNR. All rights reserved.
2003 ASNR Annual Meeting Abstracts
pathology of the cerebellar peduncles.
References
1. O'uchi T. Wallerian degeneration of pontocerebellar tracts after pontine
hemorrhage. Int J Neuroradiol 1998;4:171-177
© 2003 ASNR. All rights reserved.