title: MR anatomy of deep brain nuclei with special reference to specific diseases and deep brain stimulation localization.
abstract: Diseases affecting the basal ganglia and deep brain structures vary widely in etiology and include metabolic, infectious, ischemic, and neurodegenerative conditions. Some neurologic diseases, such as Wernicke encephalopathy or pseudohypoparathyroidism, require specific treatments, which if unrecognized could lead to further complications. Other pathologies, such as hypertrophic olivary degeneration, if not properly diagnosed may be mistaken for a primary medullary neoplasm and create unnecessary concern. The deep brain structures are complex and can be difficult to distinguish on routine imaging. It is imperative that radiologists first understand the intrinsic anatomic relationships between the different basal ganglia nuclei and deep brain structures with magnetic resonance (MR) imaging. It is important to understand the "normal" MR signal characteristics, locations, and appearances of these structures. This is essential to recognizing diseases affecting the basal ganglia and deep brain structures, especially since most of these diseases result in symmetrical, and therefore less noticeable, abnormalities. It is also crucial that neurosurgeons correctly identify the deep brain nuclei presurgically for positioning deep brain stimulator leads, the most important being the subthalamic nucleus for Parkinson syndromes and the thalamic ventral intermediate nucleus for essential tremor. Radiologists will be able to better assist clinicians in diagnosis and treatment once they are able to accurately localize specific deep brain structures.
authors.affiliation: Department of Radiology, University of Alabama at Birmingham; Birmingham, AL, USA - rtelford@uabmc.edu.
authors.forename: Ryan
authors.initials: R
authors.lastname: Telford
authors.affiliation: Department of Radiology, University of Alabama at Birmingham; Birmingham, AL, USA.
authors.forename: Surjith
authors.initials: S
authors.lastname: Vattoth
mesh_terms: D001479:Basal Ganglia / Q000473:pathology / Q000503:physiopathology; D001921:Brain / Q000473:pathology* / Q000503:physiopathology*; D001927:Brain Diseases / Q000473:pathology* / Q000503:physiopathology*; D001931:Brain Mapping; D046690:Deep Brain Stimulation; D020329:Essential Tremor / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D010300:Parkinson Disease / Q000473:pathology / Q000503:physiopathology; D020531:Subthalamic Nucleus / Q000473:pathology / Q000503:physiopathology
keywords: MR imaging; deep brain nuclei; deep brain stimulation