title: Neurological Disorders Associated with Striatal Lesions: Classification and Diagnostic Approach.
abstract: Neostriatal abnormalities can be observed in a very large number of neurological conditions clinically dominated by the presence of movement disorders. The neuroradiological picture in some cases has been described as "bilateral striatal necrosis" (BSN). BSN represents a condition histo-pathologically defined by the involvement of the neostriata and characterized by initial swelling of putamina and caudates followed by degeneration and cellular necrosis. After the first description in 1975, numerous acquired and hereditary conditions have been associated with the presence of BSN. At the same time, a large number of disorders involving neostriata have been described as BSN, in some cases irrespective of the presence of signs of cavitation on MRI. As a consequence, the etiological spectrum and the nosographic boundaries of the syndrome have progressively become less clear. In this study, we review the clinical and radiological features of the conditions associated with MRI evidence of bilateral striatal lesions. Based on MRI findings, we have distinguished two groups of disorders: BSN and other neostriatal lesions (SL). This distinction is extremely helpful in narrowing the differential diagnosis to a small group of known conditions. The clinical picture and complementary exams will finally lead to the diagnosis. We provide an update on the etiological spectrum of BSN and propose a diagnostic flowchart for clinicians.
authors.affiliation: Child Neurology Department, Neurological Institute C. Besta Foundation IRCCS, Via Celoria 11, 20133, Milan, Italy. davidetondu@hotmail.com.|Child Neuropsychiatry Unit, Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy. davidetondu@hotmail.com.
authors.forename: Davide
authors.initials: D
authors.lastname: Tonduti
authors.affiliation: Neuroradiology Department, Neurological Institute C. Besta Foundation IRCCS, Via Celoria 11, 20133, Milan, Italy.
authors.forename: Luisa
authors.initials: L
authors.lastname: Chiapparini
authors.affiliation: Child Neurology Department, Neurological Institute C. Besta Foundation IRCCS, Via Celoria 11, 20133, Milan, Italy.
authors.forename: Isabella
authors.initials: I
authors.lastname: Moroni
authors.affiliation: Child Neurology Department, Neurological Institute C. Besta Foundation IRCCS, Via Celoria 11, 20133, Milan, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Ardissone
authors.affiliation: Child Neurology Department, Neurological Institute C. Besta Foundation IRCCS, Via Celoria 11, 20133, Milan, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Zorzi
authors.affiliation: Child Neurology Department, Neurological Institute C. Besta Foundation IRCCS, Via Celoria 11, 20133, Milan, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Zibordi
authors.affiliation: Neuroradiology Department, Neurological Institute C. Besta Foundation IRCCS, Via Celoria 11, 20133, Milan, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Raspante
authors.affiliation: Molecular Neurogenetics Department, Neurological Institute C. Besta Foundation IRCCS, Via Libero Temolo 4, 20126, Milan, Italy.
authors.forename: Celeste
authors.initials: C
authors.lastname: Panteghini
authors.affiliation: Molecular Neurogenetics Department, Neurological Institute C. Besta Foundation IRCCS, Via Libero Temolo 4, 20126, Milan, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Garavaglia
authors.affiliation: Child Neurology Department, Neurological Institute C. Besta Foundation IRCCS, Via Celoria 11, 20133, Milan, Italy.
authors.forename: Nardo
authors.initials: N
authors.lastname: Nardocci
mesh_terms: D001692:Biological Transport; D006801:Humans; D007239:Infections; D009069:Movement Disorders / Q000209:etiology; D009336:Necrosis; D009422:Nervous System Diseases / Q000150:complications / Q000175:diagnosis*; D013831:Thiamine / Q000378:metabolism
chemical_list: D013831:Thiamine
keywords: Basal ganglia; Bilateral striatal necrosis; Caudate; Neostriatum; Putamen; Striatal lesions