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AJNR - American Journal of Neuroradiology

Published ahead of print on May 1, 2008
doi: 10.3174/ajnr.A1065

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Poststreptococcal Dystonia with Bilateral Striatal Enlargement: MR Imaging and Spectroscopic Findings

A.T. Karagulle Kendi^a, C. Krenzel^a, F.W. Ott^a, J.R. Brace^a, S.K. Norberg^b and S.A. Kieffer^a

^a Division of Neuroradiology, Department of Radiology, University of Minnesota Medical School, Minneapolis, Minn
^b Division of Pediatric Neurology, Gillette Children's Specialty Healthcare, St. Paul, Minn

View larger version (104K): [in this window] [in a new window]   Fig 1. Axial turbo fluid-attenuated inversion recovery image demonstrates bilateral T2 hyperintensity within the heads of the caudate nuclei, the putamina, and the external/extreme capsules. The heads of the caudate/putamina are enlarged.

View larger version (85K): [in this window] [in a new window]   Fig 2. Axial apparent diffusion coefficent map shows restricted diffusion in the heads of the caudate and the putamina bilaterally.

View larger version (32K): [in this window] [in a new window]   Fig 3. A, Initial single-voxel MR spectroscopy of the left putamen demonstrates an elevated lipid/lactate (Lac) peak and a decreased NAA peak. B, Follow-up MR spectroscopy of the right putamen shows further decrease in the NAA level with an increase in the choline (Cho)/creatine (Cr) ratio. Ins indicates myo-inositol.

View larger version (96K): [in this window] [in a new window]   Fig 4. A, Axial fluid-attenuated inversion recovery image demonstrates only a small rim of residual T2 hyperintensity at the lateral margin of the right putamen. Slightly greater T2 hyperintensity remains in the left putamen. B, Axial apparent diffusion coefficient map demonstrates complete resolution of restricted diffusion in the heads of the caudate nuclei and putamina bilaterally.