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Updated: Aug 9, 2026
Diffusion Imaging in the Rat Cervical Spinal Cord
Published on: April 7, 2015
Detection of wallerian degeneration in a newborn by diffusion magnetic resonance imaging (MRI)
Jeffrey J Neil1, Terrie E Inder
1Department of Neurology, St. Louis Children's Hospital, MO 63110, USA. neil@wustl.edu
Abstract:
We present the case of an infant with hypoxic-ischemic encephalopathy in whom wallerian degeneration is demonstrated in white-matter fiber tracts by diffusion magnetic resonance imaging (MRI). MRI was undertaken on days 2 and 9 and then at 9 months of age. On day 2, conventional MRI was normal, but diffusion MRI showed bioccipital abnormalities. On day 9, diffusion MRI showed marked abnormalities in the deep white matter of the occipital regions (left > right), corpus callosum, left posterior limb of the internal capsule, and left cerebral peduncle. Water apparent diffusion coefficient values showed a significant reduction in the left occipital white matter and corpus callosum between days 2 and 9 while demonstrating the expected pseudonormalization in cortical gray matter. Images at 9 months showed left occipital porencephaly and atrophy of the left cerebral peduncle, with the infant displaying right hemiplegia at 18 months of age. In this case, the time course of diffusion changes differed between white and gray matter, with diffusion MRI showing delayed wallerian degeneration of the cerebral white matter. This case characterizes this degeneration with clinical and follow-up MRI at 9 months of age.
Insights
Diffusion MRI detected delayed Wallerian degeneration in an infant with hypoxic-ischemic encephalopathy. This imaging technique revealed white matter changes not visible on conventional MRI, aiding diagnosis.
Area of Science:
- Neuroimaging
- Pediatric Neurology
- Neuroradiology
Background:
- Hypoxic-ischemic encephalopathy (HIE) is a major cause of neonatal brain injury.
- Early detection of white matter damage is crucial for prognosis.
- Diffusion magnetic resonance imaging (MRI) offers sensitive detection of water molecule movement in brain tissue.
Observation:
- A case study of an infant with HIE is presented.
- Serial diffusion MRI scans were performed on days 2, 9, and at 9 months post-birth.
- Conventional MRI was normal on day 2, but diffusion MRI showed bioccipital abnormalities.
Findings:
- Diffusion MRI revealed progressive Wallerian degeneration in white matter tracts, including the corpus callosum and internal capsule, by day 9.
- Apparent diffusion coefficient values showed significant reduction in affected white matter, contrasting with cortical gray matter.
- Follow-up imaging at 9 months demonstrated porencephaly and cerebral peduncle atrophy, correlating with the infant's right hemiplegia.
Implications:
- Diffusion MRI can identify delayed Wallerian degeneration in HIE earlier than conventional MRI.
- This imaging modality provides valuable insights into the timing and extent of white matter injury.
- Understanding these diffusion changes aids in predicting long-term neurological outcomes in infants with HIE.
