Abstract
Objective: To present clinical and radiographic descriptions of conditions that may feature corticospinal tract abnormalities observed on magnetic resonance imaging (MRI).
Background: Corticospinal tract lesions have a broad differential diagnosis, including neurodegenerative diseases, toxic/metabolic derangements, malignancies, autoimmune diseases, infectious diseases, and neurogenetic conditions.
Design/Methods: Review of clinical presentations and brain MRIs.
Results: Conditions that have been associated with corticospinal tract hyperintensities on brain MRI include: amyotrophic lateral sclerosis, primary lateral sclerosis, heroin leukoencephalopathy, brainstem glioma, neuro-Behcets, HIV infection, neuromyelitis optica, Krabbe A disease, adult polyglucosan body disorder, X-linked Charcot-Marie-Tooth disease, Behr syndrome, Whipple disease, and sequela of liver transplantation. We present representative images and discuss clinical and radiographic features that distinguishing these conditions.
Conclusions: Corticospinal tract lesions have a heterogenous etiology, with widely different treatments and prognoses. An understanding of these potential etiologies will assist neurologists confronted with this imaging finding.
Study Supported by: None.
Disclosure: Dr. Wallach has nothing to disclose. Dr. Stember has nothing to disclose. Dr. Valentine has nothing to disclose. Dr. Howard has nothing to disclose.
Disputes & Debates: Rapid online correspondence
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