Dorsal brainstem syndrome
Difficulty in swallowing, hypotonia and psychomotor delay. History of forceps delivery.
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Axial T2 weighted images demonstrate symmetrical hyperintensity involving the tegmentum in the region of caudal pons and medulla.
There is also associated severe hypoplasia of cerebellar vermis.
There is mild dilatation of 4th ventricle, atria and occipital horns of bilateral lateral ventricles with associated mild parenchymal volume loss of supratentorial brain.
No obvious signal changes/white matter hypoplasia/white matter cystic changes/ventricular margin irregularity of supratentorial brain.
Isolated bilateral symmetrical T2 hyperintensity in the tegmentum of the brainstem with no significant abnormality in supratentorial compartment constitutes imaging of dorsal brain stem syndrome.
Further details of the case are discussed in detail in the article Dorsal brainstem syndrome
Acknowledgement: Ajeesh Ajayan and Anoop Ajaya Kumar (MRI technicians, Azeezia Medical College, Kollam).
- Quattrocchi CC, Fariello G, Longo D. Brainstem tegmental lesions in neonates with hypoxic-ischemic encephalopathy: Magnetic resonance diagnosis and clinical outcome. World J Radiol [Internet]. 2016 Feb 28 [cited 2017 Jan 19];8(2):117–23. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26981220