radiological significance of symmetric central tegmental tract hyperintensity in pediatric patients

Background]the central tegmental tract (ctt) is an extrapyramidal tract between the red nucleus and the inferior olivary nucleus which is part of the guillain-mollaret triangle (dentato-rubro-olivary system). symmetric central tegmental tract hyperintensity (ctth) is a pediatric brain magnetic resonance imaging (mri) finding with an unclear clinical and radiological significance.[objectives]the aim of this retrospective study is to determine the radiological significance of ctth on magnetic resonance imaging (mri) in children.[patients and methods]pediatric patient’s mri from january 2015 to january 2017 were retrospectively reviewed in this case series study. patient records with presence of ctth in their mri were evaluated.[results]there were 39 out of 2981 brain mris with ctth with a prevalence of 1.3%. some ctth lesions disappeared on follow-up. in two patients, the disappearance of ctth temporally corresponded to clinical improvement. also we had patients with hemolytic uremic syndrome, autoimmune hemolytic anemia, wilson’s disease, combined immunodeficiency, bartter syndrome, and autism.[conclusion]ctth could be caused by a physiological maturation process or a physiological response of the cells in the central tegmental tract to a more widespread toxic/metabolic or ischemic insult in the brain. ctth also appears to have a transient nature in some cases. further research elucidating the pathophysiology of ctth is needed.