Presentation
Unsteady balance, tremors and limb ataxia.
Patient Data
Age: 45 years
Gender: Male
From the case:
Osmotic demyelination syndrome
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A trident-shaped area of an abnormal signal is seen involving the center of the pons with sparing of its periphery and the cortico-spinal tracts. This area elicits restricted diffusion on DWI, as well as mild high signal intensity on both T2WI and FLAIR.
Case Discussion
MRI findings are consistent with osmotic demyelination syndrome. This patient presented with alcohol withdrawal syndrome and refeeding syndrome.
Pontine strokes would be expected to not cross the midline.
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