In amyotrophic lateral sclerosis (ALS) patients, cervical magnetic resonance imagings are usually performed to rule out surgically treatable cervical cord pro-blems. So the chance to evaluate portions above cervical cord such as brainstem,
internal
capsule, and cerebral cortex is extremely rare. During evaluation of 34-year-old patient who progressively developed ALS after left brachial plexus injury, we observed bilateral, asymmetric, and high signal intensity lesions at the posterior
third
quarter of the posterior limb of internal capsule and the lateral third quarter of the cerebral peduncle on proton density image as well as T2 weighted image. The properties of these bilateral lesions suggest that they represent large,
degenerated
fibers of the corticospinal tract in ALS patient other than normal hyperintense foci in the internal capsule.
|