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Middle cerebral artery (MCA) infarction involving the striatum can cause secondary degeneration of the substantia nigra and corticospinal tract. We present a patient with subacute hemorrhagic MCA infarction in whom diffusion-weighted MR images showed high signal intensity in the ipsilateral substantia nigra and corticospinal tract. A corresponding apparent diffusion coefficient map revealed a uniformly decreased signal in the same area. This represents secondary degeneration and should not be mistaken for other pathological conditions, such as a new infarction.

magnetic resonance in medical sciences

Secondary Degeneration of the Substantia Nigra and Corticospinal Tract after Hemorrhagic Middle Cerebral Artery Infarction: Diffusion-weighted MR Findings