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Is cranial computerized tomography useful in the diagnosis of multiple system atrophy?
Author(s) -
Wenning G. K.,
Jäger R.,
Kendall B.,
Kingsley D.,
Daniel S. E.,
Quinn N. P.
Publication year - 1994
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.870090311
Subject(s) - atrophy , parkinsonism , pure autonomic failure , medicine , olivopontocerebellar atrophy , pathology , cerebellum , central nervous system disease , radiology , degenerative disease , disease , blood pressure , orthostatic vital signs
Cranial computer tomographic (CT) images of 33 patients with multiple system atrophy (MSA) and of 40 age‐matched controls were blindly analyzed by two neuroradiologists. All patients had autonomic dysfunction, all but one had parkinsonism, and 13 had cerebellar signs. The scans were judged entirely normal in 21%. Moderate or severe infratentorial atrophy was found in 42%. Cerebellar atrophy was present in 39%, and pontine atrophy was present in 18%. Of the 13 patients with cerebellar signs, only eight had cerebellar atrophy. Of the 20 patients without cerebellar signs, five had cerebellar atrophy. Supratentorial involvement was much less common and less severe. Thus, CT demonstrated system involvement that was not evident clinically in five of 33 cases (15%). However, in all five the clinical diagnosis was already evident from the presence of both autonomic and pyramidal signs in addition to parkinsonism. We conclude that CT imaging is of limited diagnostic use in individual patients with MSA.