Inferior medial pontine syndrome - Foville syndrome

Case contributed by Emmanouil Kalioras

Presentation

The onset of symptoms was left sided gaze palsy and left sided facial palsy. Underwent thrombolysis and symptoms regressed. MRI images were obtained 4 days after treatment.

Patient Data

Age: 40 years
Gender: Male

Subtle T2 hyperintense wedge-shaped area with signs of restricted diffusion located in the left inferomedial part of the pons. No clear sign of contrast enhancement.

Case Discussion

Isolated pontine infarcts account for 3% of all ischemic strokes and are caused mainly by atheromatous occlusive disease where the plaques protrude into the paramedian pontine branches, resulting in occlusion and infarction.

In this case, although the patient underwent thrombolysis 4 days prior to MRI image acquisition, areas of restricted diffusion were still present, contrary to the symptoms which regressed.

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