Dorsal brainstem syndrome

Case contributed by Manoj K V
Diagnosis almost certain


Difficulty in swallowing, hypotonia and psychomotor delay. History of forceps delivery.

Patient Data

Age: 10 years
Gender: Female

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.

Case Discussion

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).

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