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    Default Fahr's disease case pictures - NEURORADIOLOGY ATLAS

    Abnormalities of the basal ganglia and thalamus may be detected at neuroimaging in a wide variety of pathologic conditions. The causes of these abnormalities may be broadly classified as systemic or focal, some with acute onset and others with slowly progressive manifestations. The deep gray matter nuclei may be affected by toxic poisoning (by carbon monoxide, methanol, cyanide) and systemic metabolic abnormalities (eg, liver disease, hyper- or hypoglycemia, hypoxia, Leigh disease, Wilson disease, osmotic myelinolysis, Wernicke encephalopathy). Certain degenerative conditions (eg, Huntington disease, neurodegeneration with brain iron accumulation [NBIA], Creutzfeldt-Jakob disease [CJD], Fahr disease) and vascular abnormalities (venous infarction, arterial occlusion) also have a predilection for involving the basal ganglia and thalamus. Finally, some focal inflammatory and infectious conditions (neuro-Behçet disease, flavivirus encephalitides, toxoplasmosis) or neoplasms (primary central nervous system [CNS] lymphoma, primary bilateral thalamic glioma [PBTG]) may also affect the basal ganglia and thalamus on both sides.

    Although magnetic resonance (MR) imaging is the modality of choice for evaluating the basal ganglia, computed tomography (CT) may be the first line of investigation, particularly in emergency situations in which patients present with altered sensorium or acute-onset seizures. There is considerable variation and overlap in both the clinical and radiologic features of abnormalities affecting the deep gray matter nuclei. Hence, no classification scheme is foolproof, and radiologists can contribute greatly to the correct diagnosis by correlating the imaging features with available clinical and laboratory data.

    In this article, we review the MR imaging anatomy of the basal ganglia and thalamus, discuss and illustrate a wide variety of pathologic conditions of these brain structures, and discuss the radiologic assessment of these conditions.
    Fahr's disease case pictures NEURORADIOLOGY attachment.php?attachmentid=289&stc=1&d=1435536235

    MR Imaging Anatomy of the Basal Ganglia and Thalamus

    The deep gray matter nuclei include the basal ganglia and thalamus, paired structures that are situated at the base of the forebrain and have wide connections to the cortex and other parts of the brain. Although some anatomists consider the subthalamic nucleus and substantia nigra to be part of the basal ganglia and the classification of terms is somewhat controversial, in this article we restrict our discussion to abnormalities of the lentiform and caudate nuclei. On axial brain images, the lentiform nucleus and the head of the caudate nucleus can be visualized as paired symmetric structures located between the lateral ventricle and the insular cortex . The lentiform nucleus, which includes the putamen and the more medially located globus pallidus, is separated from the caudate head and the thalamus by the anterior and posterior limbs of the internal capsule, respectively. At MR imaging, the caudate nucleus and putamen are isointense relative to the cortical gray matter with all pulse sequences and do not enhance after contrast material injection. The globus pallidus is typically slightly hypointense relative to the putamen, a normal feature that is attributable to progressive iron deposition as one ages . The lentiform nucleus can also exhibit dilated Virchow-Robin perivascular spaces and bilaterally symmetric age-related calcification , both of which are considered normal findings and should not be confused with pathologic change

    RSNA Publications Online

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    Last edited by Medical Photos; 08-22-2015 at 12:26 PM.

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