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PubMed2003

Respiratory responses to pH in the absence of pontine and dorsal medullary areas in the newborn mouse in vitro.

The contribution of pons and dorsal medulla in establishing the pattern of fictive respiration and in mediating the respiratory response to acidification was studied using the isolated brainstem-spinal cord preparation from neonatal mouse. About 40% of ponto-medullary preparations (retaining pons) showed spontaneous, but irregular respiratory-like rhythm. In the other 60%, the elimination of the pons often was followed by the initiation of a respiratory-like rhythm. Medullary preparations, derived from either inactive or rhythmic ponto-medullary preparations, showed a regular respiratory-like rhythm, which was also of a higher frequency and a bigger amplitude than that observed in ponto-medullary preparations. In contrast, ventral medullary preparations, derived from medullary preparations by eliminating the dorsal medulla, showed an irregular rhythm with a reduced amplitude of the integrated inspiratory burst. In ponto-medullary and ventral medullary preparations, acidification of the superfusion medium increased the respiratory frequency, while in medullary preparations, it increased the frequency and reduced the amplitude of the inspiratory burst. Our results suggest that pontine structures influence negatively the rate and depth of the respiratory-like rhythm, while dorsal medullary structures influence positively the depth of the rhythm. They also suggest that the pattern of response to pH supported by the ventral medulla is modified by the input provided from pons and dorsal medulla.

Animals↗
PubMed1999

Neurotoxic N-methyl-D-aspartate lesion of the ventral midbrain and mesopontine junction alters sleep-wake organization.

The dorsal regions of the midbrain and pons have been found to participate in sleep regulation. However, the physiological role of the ventral brainstem in sleep regulation remains unclear. We used N-methyl-D-aspartate-induced lesions of the ventral midbrain and pons to address this question. Unlike dorsal mesencephalic reticular formation lesions, which produce somnolence and electroencephalogram synchronization, we found that ventral midbrain lesions produce insomnia and hyperactivity. Marked increases in waking and decreases in slow wave sleep stage 1 (S1), stage 2 (S2) and rapid eye movement sleep were found immediately after the lesion. Sleep gradually increased, but never returned to baseline levels (baseline/month 1 post-lesion: waking, 30.6 +/- 4.58%/62.3 +/- 10.1%; S1, 5.1 +/- 0.74/3.9 +/- 1.91%; S2, 46.2 +/- 4.74%/23.1 +/- 5.47%; rapid eye movement sleep, 14.1 +/- 3.15%/7.2 +/- 5.42%). These changes are comparable in magnitude to those seen after basal forebrain lesions. Neuronal degeneration was found in the ventral rostral pons and midbrain, including the substantia nigra, ventral tegmental area, retrorubral nucleus, and ventral mesencephalic and rostroventral pontine reticular formation. We conclude that nuclei within the ventral mesencephalon and rostroventral pons play an important role in sleep regulation.

Animals↗
PubMed1990

Pontine projection from striate and prestriate visual cortex in the macaque monkey: an anterograde study.

The projection from striate and prestriate visual cortex to the pontine nuclei has been studied in the macaque monkey by means of anterograde tracer techniques in order to assess the contribution of anatomically and functionally distinct visual cortical areas to the cortico-ponto-cerebellar loop. No projection to the pons was found from central or paracentral visual-field representations of V1 (striate cortex) or prestriate visual areas V2, and V4. Small patches of terminal labeling occurred after injections of tracer into more peripheral parts of V1, V2 and V3, and into V3A. The terminal fields were located most dorsolaterally in the anterior to middle third of the pons and were quite restricted in their rostro-caudal extent. Injections of V5, however, yielded substantial terminal labeling, stretching longitudinally throughout almost the entire pons. This projection could be demonstrated to arise from parts of V5 receiving input from central visual-field representations of striate cortex, whereas parts of V4 receiving similarly central visual-field input had no detectable projection to the pons. Its distribution may overlap to a large extent with the termination of tecto-pontine fibers and with the termination of fibers from visual areas in the medial bank (area V6 or PO) and lateral bank (area LIP) of the intraparietal sulcus, as well as from frontal eye fields (FEF). It appears that the main information relayed to the cerebellum by the visual corticopontine projection is related to movement in the field of view.

Animals↗
PubMed2004

Brainstem neurodegeneration correlates with clinical dysfunction in SCA1 but not in SCA2. A quantitative volumetric, diffusion and proton spectroscopy MR study.

Magnetic resonance (MR) techniques enable in vivo measurement of the atrophy of the brainstem and cerebellum in spinocerebellar ataxia type 1 (SCA1) and 2 (SCA2) patients, which is accompanied by a decrease in the concentration of N-acetyl aspartate (NAA) or of the NAA/creatine ratio in the pons and cerebellum. Mean diffusivity (D) is emerging as an additional sensitive and quantitative MR parameter to investigate brain diseases. In order to explore differences between the MR features of SCA1 and SCA2 and correlate the MR and clinical findings in the two conditions, we examined 16 SCA1 patients, 12 SCA2 patients and 20 healthy control subjects. The MR protocol included T1-weighted 3D gradient echo sequences, single-voxel proton spectroscopy of the right cerebellar hemisphere (dentate and peridentate region) and of the pons with a PRESS sequence and an external reference quantitation method, and (in nine patients with SCA1 and nine patients with SCA2) diffusion-weighted echo-planar images with reconstruction of the D maps. The patients were evaluated with the Inherited Ataxia Clinical Rating Scale (IACRS). Compared with control subjects, the SCA1 and SCA2 patients showed a decrease (P < 0.01) in the volume of the brainstem and cerebellum and in the concentration of NAA in the pons and cerebellar hemisphere, whereas D of the brainstem and cerebellum was increased. No significant difference was observed between the SCA1 and SCA2 patient groups. No correlation between cerebellar volume and dentate and peridentate NAA concentration was found in SCA1 or SCA2 patients. The volume of the brainstem, D of the brainstem and cerebellum and the concentration of NAA in the pons were correlated (P < 0.05) with the IACRS score in SCA1 but not in SCA2. This discrepancy is in line with the clinical observation that the clinical deficit has a later onset and faster progression in SCA1 and an earlier onset and slower progression in SCA2, and suggests that neurodegeneration of the brainstem is a comparatively more rapid process in SCA1. In conclusion, our study indicates that SCA1 and SCA2 substantially exhibit the same MR features. The correlation in SCA1 between clinical severity and quantitative volumetric, diffusion MRI and proton MR spectroscopy findings in the brainstem indicates that these measurements might be employed for longitudinal studies and hopefully as surrogate markers in future pharmacological trials of this condition.

Adult↗
PubMed2006

High-frequency oscillations in phrenic activity during pontile and medullary respiratory rhythms in rats.

High-frequency oscillations may be signatures of the basic mechanisms underlying the neurogenesis of various patterns of automatic ventilatory activity. These high-frequency oscillations in phrenic activity differ greatly in eupnoea and gasping, implying different mechanisms of neurogenesis. In a decerebrate, in situ preparation of the rat, the peak frequency of high-frequency oscillations fell in apneusis following removal of the rostral pons. Following removal of all pons, phrenic discharge had a mixed pattern of gasps and multiple bursts; some of the latter were incrementing, as in eupnoea. Regardless of pattern, peak frequencies were significantly below those which were found during eupnoea, apneusis or gasping of the decerebrate preparation. Results do not support the concept that 'non-gasping' rhythmic patterns that can be recorded following a removal of pons are generated by the same mechanisms as those generating eupnoea. Indeed, both pons and medulla appear essential for all aspects of eupnoea to be expressed.

Animals↗
PubMed1991

Noradrenergic modulation of the medullary respiratory rhythm generator in the newborn rat: an in vitro study.

1. Superfused brain stem-spinal cord preparations of newborn rats, which continue to show a rhythmic respiratory activity in vitro, were used to analyse the mechanisms whereby the A5 noradrenergic area modulates the activity of the medullary respiratory rhythm generator in the newborn. 2. In preparations including the pons (ponto-medullary preparations), noradrenaline (NA, 25-100 microM) added to the bathing medium either increased (n = 29/50) or decreased (n = 21/50) the respiratory frequency and elicited a tonic discharge in the cervical ventral roots in 50% of the experiments. Double-bath experiments showed that the increases in respiratory frequency were due to NA acting on the pons, whereas the decreases in respiratory frequency were due to NA acting on the medulla. The NA-induced increases in respiratory frequency were attributed to inhibition of A5 neurons by NA and therefore to withdrawal of A5 inhibition on the medullary rhythm respiratory generator. The NA-induced decreases in respiratory frequency seemed to mimic the effects of endogenous NA on the A5 medullary targets. 3. Noradrenaline-induced tonic activity (i) could be induced after elimination of the pons but not on isolated spinal cord, (ii) could be elicited by alpha 1- but not alpha 2-agonists, (iii) could be blocked by alpha 1- but not alpha 2-antagonists. The tonic activity therefore originated from activation of alpha 1 receptors located in the medulla but its importance in respiratory function is doubtful. 4. In medullary preparations (elimination of the pons by transection), the effects of NA agonists and antagonists on respiratory frequency were analysed. Significant decreases in respiratory frequency were induced by NA, adrenaline, phenylephrine and alpha-methyl-NA, but not by the agonists classified as alpha 2 (clonidine and guanfacine), alpha 1 (6-fluoro-NA) and beta (isoprenaline). Since yohimbine, idazoxan and piperoxane (alpha 2 antagonists) blocked the NA-induced decreases in respiratory frequency whereas prazosin (alpha 1-antagonist) did not, it is postulated that alpha 2-receptors may be involved in modulating respiratory frequency. 5. Stimulation, lesion and NA microejection experiments showed the complexity of the mechanisms mediating NA-induced changes in respiratory activity but suggested that the main site of NA action is located in the rostral ventrolateral medulla, where electrical stimulations triggered inspiration prematurely, lesions suppressed the NA-induced decrease in respiratory frequency, and localized application of NA led to an immediate decrease in the respiratory frequency.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1990

Target control of collateral extension and directional axon growth in the mammalian brain.

Individual neurons in the brain send their axons over considerable distances to multiple targets, but the mechanisms governing this process are unresolved. An amenable system for studying axon outgrowth, branching, and target selection is the mammalian corticopontine projection. This major connection develops from parent corticospinal axons that have already grown past the pons, by a delayed interstitial budding of collateral branches that then grow directly into their target, the basilar pons. When cocultured with explants of developing cortex in three-dimensional collagen matrices, the basilar pons elicits the formation and directional growth of cortical axon collaterals across the intervening matrix. This effect appears to be target-specific and selectively influences neurons in the appropriate cortical layer. These in vitro findings provide evidence that the basilar pons becomes innervated by controlling at a distance the budding and directed ingrowth of cortical axon collaterals through the release of a diffusible, chemotropic molecule.

Animals↗
PubMed2000

Course and distribution of facial corticobulbar tract fibres in the lower brain stem.

The course and distribution of the facial corticobulbar tract (CBT) was examined by correlating MRI of brain stem lesions with neurological symptoms and signs including central (C-FP) or peripheral facial paresis (P-FP) in 70 patients with localised infarction of the lower brain stem. C-FP occurred more often in patients with lesions of the lower pons or upper medulla of the ventromedial brain stem. Some patients with dorsolateral infarcts of the upper medulla to the lower pons showed C-FP, mostly on the lesion side. P-FP on the side of the lesion was also seen in patients with dorsolateral involvement of the lower pons. Patients with ventromedial infarction of the brain stem showed paresis of extremities contralateral to the lesion. Specific neurological symptoms and signs such as dysphagia, vertigo, nystagmus, Horner's syndrome, ipsilateral cerebellar ataxia, and contralateral superficial sensory impairment were seen in patients with dorsolateral infarcts of the brain stem. It is hypothesised that the facial CBT descends at the ventromedial lower pons, near the corticospinal tract, mainly to the level of the upper medulla, where the fibres then decussate and ascend in the dorsolateral medulla to synapse in the contralateral facial nucleus.

Adult↗
PubMed1989

Development and aging of brain midline structures: assessment with MR imaging.

The development and aging of four brain midline structures--the pituitary gland, pons, cerebellar vermis, and corpus callosum--were studied. The dimensions and area of these structures were measured by means of midsagittal magnetic resonance imaging. The study group consisted of 94 patients newborn to 15 years old and 49 patients and seven volunteers 16-60 years old. Except for growth spurts in the 1st year and in the 10-15-year age range, the pituitary gland showed linear growth. The pons, cerebellar vermis, and corpus callosum all showed exponential growth. The cerebellar vermis showed the sharpest 1st-year growth spurt, followed by the corpus callosum and the pons. The pituitary gland showed a decrease in size in the 51-60-year age range. The corpus callosum also showed a tendency to diminish in size but to a lesser degree. There were no statistically significant declines in the size of either the pons or the cerebellar vermis in the 51-60-year age range.

Adolescent↗
PubMed2005

New and reliable MRI diagnosis for progressive supranuclear palsy.

OBJECTIVE: To evaluate the area of the midbrain and pons on mid-sagittal MRI in patients with progressive supranuclear palsy (PSP), Parkinson disease (PD), and multiple-system atrophy of the Parkinson type (MSA-P), compare these appearances and values with those of normal control subjects, and establish diagnostic MRI criteria for the diagnosis of PSP. METHODS: The authors prospectively studied MRI of 21 patients with PSP, 23 patients with PD, 25 patients with MSA-P, and 31 age-matched normal control subjects. The areas of the midbrain tegmentum and the pons were measured on mid-sagittal MRI using the display tools of a workstation. The ratio of the area of the midbrain to the area of the pons was also evaluated in all subjects. RESULTS: The average midbrain area of the patients with PSP (56.0 mm2) was significantly smaller than that of the patients with PD (103.0 mm2) and MSA-P (97.2 mm2) and that of the age-matched control group (117.7 mm2). The values of the area of the midbrain showed no overlap between patients with PSP and patients with PD or normal control subjects. However, patients with MSA-P showed some overlap of the values of individual areas with values from patients with PSP. The ratio of the area of the midbrain to the area of pons in the patients with PSP (0.124) was significantly smaller than that in those with PD (0.208) and MSA-P (0.266) and in normal control subjects (0.237). Use of the ratio allowed differentiation between the PSP group and the MSA-P group. CONCLUSION: The area of the midbrain on mid-sagittal MRI can differentiate PSP from PD, MSA-P, and normal aging.

Aged↗
PubMed1995

Brainstem auditory evoked potentials recorded around the human upper brainstem area.

The intracranial spatiotemporal distributions of brainstem auditory evoked potentials were analyzed in two patients with epilepsy to study the dipole directions of waves III and V, previously found to have a horizontal and a vertical dipole, respectively. Depth electrodes were implanted bilaterally into the frontal and temporal lobes of these patients, the targets including the amygdala and hippocampus which are close to the upper pons and midbrain. Recordings around the upper pons and from the subcortical area downwards along the dorsal aspect of the upper pons indicated that waves III and V are constructed of mixed dipoles, wave III also having a vertical dipole segment and wave V also a horizontal one. These results suggest that several neural activities from the upper pons to midbrain contribute to the generation of waves III and V.

Adult↗
PubMed1975

5,7-Dihydroxytryptamine induced changes in the postnatal development of central 5-hydroxytryptamine neurons.

Systemic administration of the neurotoxic compound 5,7-dihydroxytryptamine (5,7-HT) to newborn rats led acutely (within 1--2 h) to a marked reduction of the in vitro uptake of [3H]5-hydroxytryptamine (5-HT) in homogenates from the cerebral cortex (75% decrease) and the pons-medulla (60% decrease). When 5,7-HT was administered postnatally we found that between days 5 an7 resistance developed in the cerebral cortex towards the 5,7-HT induced reduction in 3H-5-HT uptake. This was most likely the result of the postnatal development of the blood-brain barrier. These results show that 5,7-HT can pass the blood-brain barrier in the neonate stage and enter the brain to exert its well-known neurotoxic action on 5-HT neurons. The [3H]5-HT uptake in the cerebral cortex was reduced quantitatively to the same extent up to the 28th postnatal day, after which time a moderate recovery took place. Endogenous 5-HT was reduced by 40% in the cerebral cortex when measured in adult animals. In the pons-medulla there was a rapid recovery of the [3H]5-HT uptake during the first week after the 5,7-HT treatment and on the 14th postnatal day the increase was as much as 75% compared with the control. Endogenous 5-HT and [3H]5-HT uptake was increased by 40--50% when the analysis was performed 2 months after the 5,7-HT treatment. Studies of [3H]noradrenaline (NA) uptake after 5,7-HT administration at birth showed that this treatment similarly affected the NA neurons, though to a lesser extent. The effects on the NA neurons could be abolished by pretreatment with the "membrane pump" blocker desipramine, leaving the action of 5,7-HT on 5-HT neurons almost unaffected. Analysis of the [3H]5-HT uptake kinetics in the pons-medulla showed that the 5,7-HT treatment did not affect the Km while the Vmax was increased. It is concluded that neonatal 5,7-HT treatment produces a marked 5-HT denervation of the cerebral cortex, while there is a stimulated postnatal outgrowth of 5-HT nerve terminals in the pons-medulla, after an initial partial damage of the neurons.

Aging↗
PubMed1975

Effect of methamphetamine on norepinephrine metabolism in various regions of brain.

The effects of methamphetamine on tritiated and endogenous norepinephrine metabolism was examined in various regions of brain. In acute experiments, 30 minutes or 5 hours after methamphetamine i.p., 3H-norepinephrine was injected into the cisterna magna. In chronic experiments, rats were administered increasing doses of methamphetamine twice a day for 17 days, then 18 hours after the last dose of methamphetamine, 3H-norepinephrine was injected intracisternally. All rats were killed 5 minutes after the intracisternal injection and their brains removed, dissected into five parts and assayed for endogenous norepinephrine, 3H-norepinephrine and its metabolites. In rats treated acutely, methamphetamine caused a significant block in uptake of 3H-norepinephrine and a marked increase in the content of 3H-normetanephrine in all regions except the cortex. Five hours after methamphetamine administration, increased levels of 3H-norepinephrine occurred in the pons-medulla, whereas endogenous norepinephrine content tended to decrease in most regions. In rats treated chronically, enhanced accumulation of 3H-norepinephrine was also confined to the pons-medulla region, whereas endogenous levels of norepinephrine were high in the pons-medulla and low in the hypothalamus and cortex. These data suggest that chronic administration of methamphetamine affects either catecholaminergic nerve cell bodies or nerve terminals in the pons-medulla differentially, as compared to other regions studied.

Animals↗
PubMed2005

Pontine norepinephrine content after motor cortical ablation in rats.

It has been reported that norepinephrine (NE) plays an important role in recovery after brain damage. However, the role of the pons, the site where the norepinephrinergic locus coeruleus (LC) is located, has not been elucidated. In order to study the changes in the pontine NE content in either noninjured, injured or recovered rats, we used 35 animals trained to walk across to a walkway where their footprints were recorded. Subsequently, 17 trained rats were sham-operated while 18 were injured by means of an ablation of the right motor cortex representative of the hindlimb. From the injured rats, 6 were sacrificed 6 hr before surgery in order to obtain the pons, while all the remaining rats were recorded in the walkway 6, 24 and 48 hr post-surgery. Then, rats were sacrificed by decapitation, the pons was removed and each hemisphere was prepared for the chromatographic analysis of NE. Results showed that after cortical brain damage, the length of the stride decreased while the angle of the stride increased 6 hr post-surgery. Recovery was observed after 24 hr. NE increased in the pons after 6 hr and returned to normal levels when rats had recovered. This suggests that cortical damage elicits NE changes in the LC that could reorganize the system to lead the recovery process. Such findings must be taken in account when pharmacotherapy with antidepressants or antipsychotics that act on norepinephrine-containing neuronal systems are prescribed in patients after stroke.

Animals↗
PubMed1987

Respiration and airway reflexes after transversal brain stem lesions in cats.

The effect of brain stem transection at different levels of the pons Varolii and the medulla oblongata on respiration and on cough and the aspiration and expiration reflex elicited by mechanical stimulation of the relevant parts of the respiratory tract was studied in experiments on 13 anaesthetized, unparalyzed cats. The results of 142 respiratory reflex elicitation tests showed that: 1. Compared with the control state, transection of the upper and middle part of the pons Varolii and transection at the level of the pontomedullary junction reduced the respiration rate (p less than 0.001), increased the duration of inspiration and expiration (p less than 0.001, transection 10 mm rostrally to the obex) and gave rise to apneustic breathing (8 mm), or to tonic, respiration-modulated activity of the phrenic nerve and diaphragm (6 mm). 2. Successive transection of the pons and the pontomedullary junction region led chiefly to a drop in maximum expiratory pleural pressure values (p less than 0.01-0.001) during cough and the expiration reflex and to a drop in maximum inspiratory pleural pressure values during the aspiration reflex (p less than 0.02-0.001). 3. Transection of the upper part of the medulla oblongata always led to permanent arrest of rhythmic respiration, during which cough and the expiration reflex could not be elicited while the aspiration reflex persisted (though in a weakened form). This state was followed by gasping, during which only a highly elicitable aspiration reflex persisted. 4. It can be assumed from the above findings that the central mechanisms responsible for the development of powerful expiratory efforts in cough and the expiration reflex could be localized in the pons Varolii, while those integrating the aspiration reflex are probably localized mainly in the medulla oblongata.

Animals↗
PubMed1980

Patterns of organization of comments on the corticopontine projection in the cat with the pontocerebellar projection.

Following lesions of various parts of the cat cerebral cortex, the distribution of degenerating fibers in the pontine nuclei was mapped in drawings of serial transverse and horizontal sections of Fink and Heimer. All parts of the cerebrum give rise to the corticopontine fibers and each functionally uniform area has its particular projection zones in the pons. Thus, it has been shown that the pontine projection zones from the sensorimotor, auditory, orbital, cingulate and "association" cortices are arranged in longitudinal columns throughout the pons, mostly in well delimited columns, while those from the visual cortex reveal columns oriented transversely in the rostral part of the pons. When the distribution of the pontine afferents from various parts of the cortex are compared in detail, it is evident that there are differences in locations of the columns, clustered in continuous zones of terminations, among different pontine projections, although there are partial overlaps among these projection zones. The present as well as the previous findings of the corticopontine projection are correlated with observations of the pontocerebellar projection obtained by other investigators with the horseradish peroxidase and the autoradiographic methods, and a possible propagation of different modalities of sensations from the cerebral cortex, via the pons, to the cerebellum is discussed with reference to some physiological data. The present study largely confirms and extends the previous data of the corticopontine projection and reveals that the cortico-ponto-cerebellar pathways are more cmplexly organized than was previously assumed.

Afferent Pathways↗
PubMed1993

[Bilateral abducens nerve palsy followed by pseudoathetosis due to pontine hemorrhage--clinical and neuroradiological study].

Reported here are two cases with pontine hemorrhage presented with bilateral abducens nerve palsy and followed by pseudoathetosis, ataxia, and hemiparesis on the contralateral side of the lesion. The first case, a 57-year-old man, who suffered from bilateral abducens nerve palsy, deafness and hypoesthesia, ataxia, and hemiparesis of the right side of the body. MRI showed the confined lesion in the left side of tegmentum at the level of middle pons. When the abducens nerve palsy began to improve, pseudoathetosis of the right fingers appeared. About six months later, symptoms almost recovered, except for ataxia. The second case, a 48-year-old man who suffered from bilateral abducens nerve palsy, deafness of the left ear, and ataxia, hypoesthesia, and hemiparesis of the left side of the body was admitted. MRI disclosed a small lesion on the right side of the tegmentum at the level of middle pons. When the bilateral abducens nerve palsy was beginning to improve, pseudoathetosis of the left hand appeared. Three months later, pseudoathetosis of the left hand disappeared. Both patients presented here had a similar lesion in the tegmentum at the level of middle pons on the side contralateral to the side in which the pseudoathetosis was seen. Considering the clinical symptoms and radiological findings of these cases, it appears that a lesion which causes such rare neurological symptoms may involve the medial lemniscus, spinothalamic tract, lateral lemniscus, spinocerebellar fiber, and central tegmental tract at the tegmentum of the middle pons on the side contralateral to the cerebellar signs and pseudoathetosis.

Abducens Nerve↗
PubMed1996

[Multiple cerebral telangiectasias. Apropos of an anatoma-radioclinical case].

UNLABELLED: Telangiectasias are vascular malformations corresponding to dilated capillary separated by nervous parenchyma. They are generally asymptomatic and discovered during autopsy. CASE REPORT: We describe the case of a 2-year-old girl who was admitted for drowsiness and vomitings with craniomegaly and right hemiparesis. The cerebral imaging demonstrated large amounts of calcium in the region of pons and left thalamus with a contrast enhancement throughout these calcifications. The thalamic lesion was cystic with obstruction of the third ventricle and hydrocephalus. There were multiple calcifications scattered throughout the basal ganglia and the white matter. The latter had a low density on CT and high signal intensity on MRI (T2). The cerebral angiographic study showed a blush in the pons and the thalamus. Clinical course was fluctuating or intermittently progressive. Finally, in spite of radiotherapy and oral corticosteroid treatment, the child became quadriparesic with oculomotor palsy. She suddenly died at age 4 years and 6 months from a hemorrhage of the pons. Neuropathological study showed two clusters of telangiectasias with calcifications in the pons and the thalamus. Other calcified vascular malformations were seen in the white matter and the basal ganglia. Near the lesions, astrocytar gliosis and edema were observed. The white matter was malacic with isolated calcifications. CONCLUSION: Cerebral telangiectasias may be multiple and may produce severe neurologic disorders, occurring in infancy with fluctuating clinical course. Arteriography may show these usually cryptic vascular malformations. This diagnostic should be kept in mind in view to the neuroradiological aspect we report here.

Basal Ganglia↗