Central pontine myelinolysis

Case contributed by Frank Gaillard
Diagnosis possible

Presentation

History unknown.

Patient Data

Age: Elderly
mri

High T2 and DWI signal in the pons, sparing the periphery in a patient with atrophy, which appears more marked in the cerebellum. Note how the signal abnormality crosses the mid-line making ischemia unlikely, as the pontine perforators are end-arteries which do not cross the mid-line.

Case Discussion

Unfortunately I do not have evidence supporting the diagnosis central pontine myelinolysis. Nonetheless in a patient with cerebellar atrophy this is the likely diagnosis. 

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