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Neuronal Loss in the Pedunculopontine Tegmental Nucleus Ipsilateral to a Massive Cerebral Infarct

This report describes the striking ipsilateral loss of large and medium‐sized neurons in the pedunculopontine tegmental nucleus‐pars compactus (PPTN‐pc) in an 82‐year‐old man with a massive, long‐standing infarct in the left cerebral hemisphere (area of the middle cerebral artery). No pathologic alterations were evident in the remaining neurons. The neurons in the contralateral PPTN‐pc were well preserved. Since the PPTN‐pc receives inputs from the basal ganglia and the cerebral cortex and sends widespread efferent fibers to the ipsilateral sides of these structures, it could be assumed that the observed loss of neurons is a result of anterograde transneuronal degeneration or of retrograde degeneration.