MRI
Disproportionate atrophy of midbrain is seen with concavity of its superior and dorsolateral margins.
Midline sagittal midbrain to pons area ratio is ~ 0.12 (reduced; normal value is ~ 0.24). Mid brain to pons width ratio is approx. 0.4 (reduced).
Convexity sulci and lateral ventricles are prominent, likely age related atrophy.
Chronic lacunar infarcts, confluence and discrete area of ischemic demyelination are seen in pons, bilateral lentiform nuclei, periventricular, deep and subcortical white matter.
Focal microhaemorrhage is seen in left cerebral peduncle.
Linear hypointense area is seen in pons in midline with blooming on GRE images, possibly representing a developmental venous anomaly or capillary telangiectasia.