Fig 4.

Wallerian degeneration in a 76-year-old man with a large right MCA infarct (6 days after onset).

A, T2-weighted image shows a hyperintense right MCA infarct, including the left putamen and caudate head.

B and C, DW images at the level of the midbrain reveal hyperintense lesions with decreased ADC, not only in the right MCA are, but also in the right cerebral peduncle (arrow) including the substantia nigra (arrowhead). This finding is presumably due to the excitotoxic injury propagated through transaxonal and transynaptic routes along the fiber tracts.