Descending corticospinal tract Wallerian degeneration after stroke: an old sign, a new prognostic marker?

Abstract

right hemiplegia reached its plateau at month-3 (FIM motor score: 42/91). At that time, MRI revealed the signs of descending corticospinal tract Wallerian degeneration (DCST-WD) (Fig. 2). The MRI feature of DCST-WD is prolonged T2 relaxation times with or without shrinkage of ipsilateral cerebral peduncle and pons [1]. This feature is more evident 3–6 months after stroke but can appear as early as 5 weeks and could persist for more than 10 months [1]. Recent studies suggest that early or serial DCST-WD signs on MRI or diffusion weighted or diffusion tensor imaging might be new biological markers of motor prognosis after stroke [2].