Unilateral right paramedian infarction of thalamus and midbrain
Diagnosis almost certain
Presentation
Impaired eye movements and left-sided motor hemineglect.
Patient Data
Age: 65 years
Gender: Male
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Abnormal signal area (high on T2/FLAIR) diffusion restriction is present it the right thalamus dorsomedial nucleus and paramedian midbrain related to ischaemic stroke events.
High signal foci in T2 and FLAIR sequences in the subcortical and periventricular white matter of both cerebral hemispheres depicts microvascular ischaemic events.
Case Discussion
The paramedian infarct is rarely found as an isolated lesion and always seen bilaterally when there is only one arterial pedicle.