MRI: early onset of changes in Wallerian degeneration

T2-weighted spin echo scans were performed on a neonate and two adults aged 42 and 60 years within 2 weeks of the onset of infarction in the frontoparietal region of the brain. Areas of increased signal intensity were observed in the anterior and posterior limbs of the internal capsule in the infant and in the posterior limbs of the internal capsules in the adults. Although these signal changes were typical of the chronic phase of Wallerian degeneration, their onset was much earlier than the 10-14 weeks previously described for this stage in adults. The low level of myelination of white matter tracts at birth, and the relatively sparse myelination of the parietopontine tract may account for the rapid onset of changes in these patients which more closely follows the time course described pathologically for Wallerian degeneration in unmyelinated fibres.