WEBINO - in a patient with midbrain infarct

Case contributed by Dr Paresh K Desai

Presentation

55 year old with Wall Eyed Bilateral Internuclear Ophthalmoplegia

Patient Data

Age: 55

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Case Discussion

MRI brain reveals a small paramedian mid brain infarct

Findings:

Figure 1:

FLAIR axial image (A) through midbrain – No abnormal signal intensity in the mid brain; 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) and 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

Final diagnosis: mid brain and cerebellar infarcts.

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Case information

rID: 12577
Case created: 18th Dec 2010
Last edited: 19th Dec 2015
Inclusion in quiz mode: Included

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