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Images in Medicine

Year : 2020 Month : October-December Volume : 9 Issue : 4 Page : RI01 - RI05

Pictorial Review of Basal Ganglia and Thalamic Lesions


S Shyam, Srikanth Vankineni, KR Parthasarathy, G HShashank, Bava Mehthab
1. Assistant Professor, Department of Radiodiagnosis, SSIMS&RC, Davangere, Karnataka, India. 2. Assistant Professor, Department of Radiodiagnosis, SSIMS&RC, Davangere, Karnataka, India. 3. Professor and Head, Department of Radiodiagnosis, SSIMS&RC, Davangere, Karnataka, India. 4. Junior Resident, Department of Radiodiagnosis, SSIMS&RC, Davangere, Karnataka, India. 5. Junior Resident, Department of Radiodiagnosis, SSIMS&RC, Davangere, Karnataka, India.
 
Correspondence Address :
Srikanth Vankineni,
Assistant Professor, Department of Radiology, SSIMS&RC, Davangere, Karnataka, India.
E-mail: vsc4444@gmail.com
Keywords : Artery of percheron infarct, Dengue encephalitis, Osmotic demyelinosis, Toxic encephalopathy MRI
 
INTRODUCTION

Basal ganglia (BG) are paired symmetric subcortical (deep grey matter) nuclei that form the core of the extrapyramidal system and control motor activity. BG pathologies manifest clinically as movement and tone dysfunction; some may present with alteration in higher mental functions such as behavioural problems, memory and other thought processes (1).

Magnetic Resonance (MR) imaging is the modality of choice for evaluating the BG. Computed Tomography (CT) may well be the primary investigation, mainly in emergency situations in which patients present with altered sensorium or acute onset seizures (2). Based on the clinical history, involvement of other brain structures in MRI and the relative laboratory findings, accurate diagnosis is reached. Clinical and laboratory findings correlation is essential to reach accurate diagnosis (2).

In this pictorial review, we have described different cases affecting BG and thalamus in our Institute. Vascular conditions like infarcts, haemorrhage, cerebral venous thrombosis, Hypoxic Ischaemic Encephalopathy (HIE), toxic conditions like methanol and Carbon monoxide (CO) poisoning, metabolic conditions like hypo and hyper glycaemia, pontine demyelinosis and few infectious conditions like dengue encephalitis and Acute necrotising encephalitis were encountered (Table/Fig 1) (3),(4),(5),(6),(7),(8),(9),(10),(11).
 
REFERENCES
1.
Finelli PF, DiMario FJ Jr. Diagnostic approach in patients with symmetric imaging lesions of the deep graynuclei. Neurologist. 2003;9(5):250-61.
2.
Kretschmann HJ, Weinrich W. Neurofunctional systems. In: Kretschmann HJ, Weinrich W, eds. Cranial neuroimagingand clinical neuroanatomy: atlas of MR imaging and computed tomography. 3rd ed. New York, NY: Thieme, 2003;383-87.
3.
Sandvig A, Lundberg S, Neuwirth J. Artery of Percheron infarction: a case report. J Med case Rep. 2017;11(1):221.
4.
Ghei SK, Zan E, Nathan JE, Choudhri A, Tekes A, Huisman TA, et al. MR imaging of hypoxic-ischemic injury in term neonates: pearls and pitfalls. Radiographics. 2014;34(4):1047-61.
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Muttikkal TJ, Wintermark M. MRI patterns of global hypoxic-ischemic injury in adults. J Neuroradiol. 2013;40(3):164-71.
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Hopkins RO, Fearing MA, Weaver LK, Foley JF. Basal ganglia lesions following carbon monoxide poisoning. Brain Injury. 2006;20(3):273-81.
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Elkhamary SM, Fahmy DM, Galvez-Ruiz A, Asghar N, Bosley TM. Spectrum of MRI findings in 58 patients with methanol intoxication: Long-term visual and neurological correlation. Egypt J Radiol Nucl Med.. 2016;47(3):1049-55.
8.
Garg P, Aggarwal A, Malhotra R, Dhall S. Osmotic demyelination syndrome- Evolution of extrapontine before pontine myelinolysis on magnetic resonance imaging. J Neurosci Rural Pract. 2019;10(01):126-35.
9.
Mizuguchi M, Abe J, Mikkaichi K, Noma S, Yoshida K, Yamanaka T, Kamoshita S. Acute necrotising encephalopathy of childhood: a new syndrome presenting with multifocal, symmetric brain lesions. J Neurol Neurosurg Psychiatry. 1995;58(5):555-61.
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Hansford BG, Albert D, Yang E. Classic neuroimaging findings of nonketotic hyperglycemia on computed tomography and magnetic resonance imaging with absence of typical movement disorder symptoms (hemichorea-hemiballism). J Radiol Case Rep. 2013;7(8):1-9.
11.
Ooi HW, Er C, Hussain I, Kuthiah N, Aravamudan VM. Bilateral basal ganglia calcification: Fahr’s disease. Cureus. 2019;11(6):e4797.
 
TABLES AND FIGURES
[Table / Fig - 1]  [Table / Fig - 2]  [Table / Fig - 3]  [Table / Fig - 4]  [Table / Fig - 5]  [Table / Fig - 6]  [Table / Fig - 7]  [Table / Fig - 8]  [Table / Fig - 9]  [Table / Fig - 10]  [Table / Fig - 11]  [Table / Fig - 12]  [Table / Fig - 13]  [Table / Fig - 14]  [Table / Fig - 15]
 
 
 

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