T1-weighted images (TR 400 msec/ TE 9 msec) of the same patient at 42 years of age. (a) A cross-section at the pontine level shows cerebellar cortex atrophy. (b) An image of a midbrain section demonstrates the hypointense change in the substantia nigra. (c) An image at the level of the basal ganglia shows symmetrical hypointense signals in the head of the caudate nucleus and globus pallidus. As compared with the findings at 35 years, the hypointense signals in the pallidum extend to the putamen. The cystic changes of the lenticular nuclei can be clearly observed. The shape of the cyst is fan shaped and exactly fits the region of the lenticular nucleus. The cerebral cortex in the frontal lobes is atrophic. The hypointense lesion in the caudate head observed in the image at 35 years of age seems to be combined with the hypointense signal of the anterior horn of the lateral ventricle. (d) In this image, enlargement of the lateral ventricles is evident. (e) This image shows cerebral cortical atrophy.
