Asymmetrical putaminal atrophy in parkinsonism-predominant multiple system atrophy (MSA-P): A case report

Koichiro Mori; Akira Yagishita; Toshio Shimizu

doi:10.1016/j.radcr.2023.05.060

Asymmetrical putaminal atrophy in parkinsonism-predominant multiple system atrophy (MSA-P): A case report

Radiol Case Rep. 2023 Jun 20;18(9):2975-2977. doi: 10.1016/j.radcr.2023.05.060. eCollection 2023 Sep.

Authors

Koichiro Mori^{1

2}, Akira Yagishita¹, Toshio Shimizu¹

Affiliations

¹ Department of Neuroradiology, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan.
² Department of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan.

Abstract

We encountered a case of multiple system atrophy parkinsonian subtype (MSA-P) with right-dominant parkinsonism in the early stage of the disease. Atrophy of the posterolateral putamen and iron deposition are the neuropathological hallmark of MSA-P. Coronal fluid-attenuated inversion-recovery (FLAIR) images showed atrophy and iron deposition in the left posterior putamen contralateral to the clinical dominant side in the early phase. Atrophy in the posterior putamen of patients with MSA-P was more clearly observed on coronal FLAIR images than on axial T2-weighted images. These findings reflected the pathological changes and might be a pathognomonic sign of MSA-P.

Keywords: Asymmetrical parkinsonism; FLAIR; Lateral medullary laminae; Putamen.

Publication types

Case Reports