[Putaminal signal hypointensity on T2 weighted MR image in a patient with corticobasal degeneration]

In the course of a 74-year-old woman with corticobasal degeneration (CBD), bilateral putaminal signal hypointensity appeared on T2 weighted MR image. This right-handed woman noticed progressive difficulty in writing and using chopsticks during two years. Neurological examination in February 1998 showed apraxia, rigidity, akinesia and myoclonus, which were more marked in the right hand side. MRI revealed atrophy of the left frontotemporal lobes. These findings were compatible to CBD. Her symptoms progressed slowly. On re-admission due to aspiration pneumonia in December 1998, she showed difficulty in swallowing and walking in addition to the signs and symptoms described above. MRI revealed bilateral putaminal signal hypointensity on T2 weighted image. In the literature, totally 9 cases in 2 reports showed similar putaminal signal hypointensity. Although this finding is unusual in CBD, advanced degenerative process in the putamen might have induced this change due possibly to the accumulation of iron secondary to the nerve cell loss.