Wall-eyed bilateral internuclear ophthalmoplegia (WEBINO) - midbrain infarct
Diagnosis almost certain
Presentation
Patient with wall eyed bilateral internuclear ophthalmoplegia
Patient Data
Age: 55 years
Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/12797/annotated_viewer_json?lang=us"}
MRI brain reveals a small paramedian mid-brain infarct.
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/12798/annotated_viewer_json?lang=us"}
Figure 1:
- FLAIR axial image (A) through midbrain – No abnormal signal intensity in the midbrain
- T2_3D axial image (B) through midbrain – subtle hyperintense signal in the left paramedian midbrain
- this lesion shows diffusion restriction on DWI (horizontal arrow on C)
- ADC map (vertical arrow on D) which is classic of acute infarct
Figure 2: Acute infarcts in the left cerebellar hemisphere on a lower section through cerebellum seen as areas of diffusion restriction on DWI.
Case Discussion
Final diagnosis: mid-brain and cerebellar infarcts.
Unable to process the form. Check for errors and try again.