Chronic spastic atrophic hemiparesis with benign course

We present the clinical and neuroimaging data of 4 patients (mean age: 62 years, range 54-67; mean follow-up: 19.5 years, range: 26 months-29 years) with chronic spastic atrophic hemiparesis (CSAH). Neuroimaging findings were non specific, CT scan and MRI showing white matter lesions located within the centrum semiovale in two cases, parieto-occipital lobe and pons in one case each. This study underlines that patients with CSAH may have a good long-term prognosis. MRI studies may demonstrate associated lesions within the white matter or brainstem and are advisable in all subjects with CSAH, but further studies are necessary to clarify the nature of the observed lesions.