Presentation
Dysarthria and right-sided hemiparesis.
Patient Data
The left paramedian part of the inferior pons demonstrates abnormal high T2 signal, low T1 signal, and diffusion restriction, in keeping with an acute pontine infarction without a hemorrhagic component.
Vertebrobasilar dolichoectasia is noted.
Bilateral eye staphyloma with high T2 signal of left eye lens suggestive of cataract.
Case Discussion
MRI features of left-sided acute paramedian pontine infarct, also known as inferior medial pontine syndrome (Foville syndrome). It is a common infarct of the vertebrobasilar system and occurs due to thrombosis of paramedian perforating branches of the basilar artery. Note how the abnormality spares the very outer parts of the pons and does not cross the midline. The main effect of this infarct is dysarthria and contralateral hemiparesis 1.