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Central pontine infarct MRI

Clinical and radiologic correlations of central pontine

  1. Clinical and radiologic correlations of central pontine myelinolysis syndrome Clinical outcome in patients with CPM is not predicted by the volume of radiologic T2 signal abnormality on MRI or the severity of hyponatremia. Serial brain imaging is of value because a substantial proportion of patients have normal findings on initial MRI
  2. ations during a period of 6 months (within 7 days of onset, 14, 30, 90, and 180 after onset). Fractional anisotropic values were measured in the medulla, cerebral peduncle, internal capsule, and centrum semiovale
  3. Central pontine myelinolysis (CPM) is now more commonly referred to as osmotic demyelination syndrome, which recognizes that the same phenomenon is also seen in other areas of the brain (previously known as extrapontine myelinolysis) 1. As such the condition is described in the osmotic demyelination syndrome article
  4. The clinical, radiologic, and neuropathologic findings in 13 patients with central pontine myelinolysis were reviewed. Antemortem computed tomography (CT) had been performed in nine, and ante- or postmortem magnetic resonance (MR) imaging in 11. Chronic alcoholism or rapid correction of hyponatremia was present in over 75% of cases

The pontine areas that were hyperintense on T2W MRI showed white matter pallor with reactive astrocytosis, primarily in the central parts of the pons, with arteriosclerotic changes in the small arteries. The authors also saw lacunar infarcts in and around these areas Central pontine myelinolysis (CPM) is an osmolar disturbance resulting in demyelination that is initially difficult to detect with convention CT and MR imaging. The literature includes several cases in which the temporal evolution of CPM is followed with serial imaging (1 - 3) Computed tomography shows a subtle hypodensity in the right pontine region. Case Discussion This examination shows a pontine ischemic stroke despite the fact that it is difficult to evaluate by computed tomography due to the presence of beam-hardering artifact Epidemiology. Although many different brainstem stroke syndromes have been classically described, the majority appear extremely rarely in the literature and are mainly for historical interest only 1.The most common brainstem stroke syndrome seems to be the lateral medullary syndrome (Wallenberg syndrome) 1.. Clinical presentatio It can present with central pontine and/or extrapontine myelinolysis (Figure 13). 117 The pontine lesion is centrally located and spares the corticospinal tracts. 118 The extrapontine lesions are symmetric and involve the thalamus, basal ganglia and lateral geniculate body and cerebellar white matter. 118 The T2 hyperintensity may lag up to 2.

of magnetic resonance imaging-confirmed pontine infarction is a strength of our study. In conclusion, our data show that dysphagia is a frequent symptom among patients with pontine infarction. Patients should be carefully examined for the presence of dysphagia, in particular if NIHSS values are high and upper and antero More formally, an ischemic stroke in the pons is also known as a pontine infarct or pontine cerebrovascular accident. As the stroke is happening, brain cells begin to die from the deprivation of oxygen-rich blood. Therefore, learning to recognize the symptoms of pontine stroke is essential for reducing death and disability We retrospectively selected patients for investigation who showed a central pontine lesion on MRI. Patients with a pontine lacunar infarction and/or arteriosclerotic ischemic central pontine lesion were excluded. We selected 11 patients, including 9 men and 2 women with a mean age of 53 years (range 31-62)

Pontine Infarction: Diffusion-Tensor Imaging of Motor

Bilateral pontine infarcts, which are less common, remain paramedian in distribution. Lateral pontine infarcts are uncommon. The differential diagnosis for a unilateral pontine lesion includes multiple sclerosis (MS), whereas for bilateral central lesions the differential diagnosis includes central pontine myelinolysis and pontine glioma Central pontine myelinolysis—axial and coronal T2-weighted images show T2 hyperintense signal involving the central pons with peripheral pontine sparing (red circle) and sparing of the corticospinal tracts (blue arrows). This pattern of involvement results in a T2 bat wing or trident appearance on axial imaging Infarction. The thalamus is The osmotic demyelinating syndrome, formerly called central pontine myelinolysis (because of the frequent pontine involvement) or extrapontine myelinolysis (when other than pontine lesions are present), can be seen with any kind of osmotic gradient changes. Magnetic resonance imaging evaluation of cerebral.

Central pontine myelinolysis Radiology Reference Article

Summary: Two cases of pontine infarct with Wallerian degeneration (WD) of the pontocerebellar fibers are described. WD of pontocerebellar fibers, seen bilaterally along the transverse pontine fibers, is more visible in the middle cerebellar peduncles and extends into the white matter of the cerebellar hemispheres ring enhancing lesion with central restricted diffusion (Fig. 23 on page 29, Fig. 24 on page 30, Fig. 25 on page 31, Fig. 26 on page 32). VASCULAR ABNORMALITIES • Acute bilateral pontine infarct Pontine infarcts are one form of brainstem infarction involving the posterior circulation Isolated pontine infarctions are usually classified into two types: paramedian pontine infarcts (PPIs) and lacunar pontine infarcts (LPIs), i.e., small deep pontine infarcts (SDPIs), according to the lesion shapes and locations [ 1, 2 ]. In PPI, the infarct abuts on the basal surface of the pons

Central pontine myelinolysis and its imitators: MR

  1. MRI confirmed that the pontine infarction with PMH or hemiplegia accounted for 10.2% (12/118) of all first-ever ischemic stroke patients and 24% (12/50) of patients with PMH or hemiplegia who had acute negative brain CT
  2. Imaging Findings On MRI, there is omega shaped T2/FLAIR hyperintensity involving the central tegmentum of pons with characteristic sparing of the periphery. This is suggestive of pontine myelinolysis (Figure 3). In addition, there is symmetrical hyperintensity involving the caudate and lentiform nucleus and also partly the thalamus (Figure 1 & 2)
  3. MRI is more sensitive than CT in imaging the pontine lesions; however, even MRI may be unremarkable early in the course of central pontine myelinolysis. The most common MRI finding is an area of decreased T1 signal or increased T2 signal within the basis pontis ( Fig. 200-5 )
  4. ately iatrogenic (treatment-induced), and is characterized by acute paralysis, dysphagia (difficulty swallowing), dysarthria (difficulty speaking), and other neurological symptoms

Central pontine myelinolysis (CPM) was described by Adams and colleagues in 1959 as a disease affecting alcoholics and the malnourished. 1 The concept was extended from 1962 with the recognition that lesions can occur outside the pons, so-called extrapontin Pontine infarcts form around 7% of all ischemic strokes, and isolated pontine strokes contribute to around 15% of all posterior circulation infarcts . Mostly, they are lacunar infarcts involving basilar artery perforators and other posterior circulation small vessels , with hypertension being a major risk factor [3,6] The isolated upbeat nystagmus (without rotatory component), no latency, no attenuation or resistance to the Eppley maneuver are red flags that should prompt the clinician to order an MRI. This is the first report of a patient with central upbeat positioning nystagmus caused by a pontine lacunar stroke

Objective: This study aims to investigate location-specific functional remodeling following ischemic stroke in pons and corona radiata.Methods: This study was approved by the local Institutional Review Board. Written consent was obtained from each of the participants prior to the MRI examination. Thirty six subjects with first ever acute ischemic stroke in pons (PS, n = 15, aged 62.8 ± 11.01. Pontine infarction treatment is akin to other types of ischemic stroke with some variability considering the lack of strong clinical evidence in posterior circulation stroke treatment compared to anterior circulation. This is especially true in patients with a large vessel occlusion, causing a pontine stroke MRI brain showed diffuse pontine signal abnormality consistent with central pontine myelinolysis. The MRI brain showed hyperintense T2 signal changes in both sides of the pons and fairly symmetrical patchy high T2 signal changes in both thalami on axial FLAIR (Fig 1) and T2 (Fig 2) Summary: Central pontine myelinolysis (CPM) occurs in the setting of rapidly corrected hyponatremia, especially in chronically debilitated patients. Conventional CT and MR imaging findings lag the clinical manifestations of CPM. We present a case in which restricted diffusion was identified within the central pons by using MR diffusion-weighted imaging within 24 hours of onset of patient.

Acute pontine infarct | Radiology Case | RadiopaediaNeuropathology Laboratory

T2-Weighted Hyperintense MRI Lesions in the Pons - Strok

An infarct localized to the paramedian pontine base was seen in 27 patients (55.1%). Among these, a unilateral basal infarct was found in 25 patients and bilateral infarcts in 2 patients. Dysarthria was noted in all 27 patients and supranuclear facial palsy in 21 (77.8%). Four patients (14.8%) had a brachial monoparesis Brain MRI disclosed a heart appearance lesion in the pons, which was high on diffusion-weighted image MRI and low on apparent diffusion coefficient map MRI. Brain MRA demonstrated that the basilar artery remained intact. A diagnosis of fresh, bilateral pontine infarction with a heart appearance was made A pontine cerebrovascular accident (also known as a pontine CVA or pontine stroke) is a type of ischemic stroke that affects the pons region of the brain stem. A pontine stroke can be particularly devastating and may lead to paralysis and the rare condition known as Locked-in Syndrome (LiS) Brain MRI revealed paramedian pontine infarct . FIG. 1 The patient was treated with aspirin, and 3 months later, she had residual left upper extremity weakness and increased tone, left sensory deficits to light touch in the arm, leg, and face, occasional occipital headaches, and moments of burning right eye pain MRI will classically demonstrate a trident-shaped, central pontine signal intensity. In the acute phase, DWI reveals restricted diffusion and corresponding low ADC values. 36 Acute disseminated encephalomyelitis and multiple sclerosis may result in similar signal intensity changes masquerading as acute ischemic events, but enhancement.

1. Arch Neurol. 1997 Aug;54(8):935-6. Central pontine myelinolysis in a patient with classic heat stroke. McNamee T, Forsythe S, Wollmann R, Ndukwu IM One-and-a-half syndrome in pontine infarcts: MRI correlates. Neuroradiology. 1999 Sep; 41(9):666-9. N. Abstract. The one-and-a-half syndrome is characterised by a lateral gaze palsy in one direction and internuclear ophthalmoplegia in the other. It is due to a unilateral lesion of the dorsal pontine tegmentum, involving the ipsilateral. MRI is far more sensitive than CT in the diagnosis of acute ischaemic stroke for all vascular territories, with study results indicating 80-95% sensitivity in the first 24 hours when diffusion weighted imaging is used, versus 16% sensitivity with CT.27 28 Sensitivity may be lower in the posterior circulation and false negatives can occur with. Pontine stroke is a type of stroke that happens when the blood flow in the brain stem is disrupted. The brain stem is responsible for breathing, heart function, digestion and alertness. Pontine stroke is very dangerous. Know the causes, symptoms, treatment, recovery period, survival rate and prognosis of pontine stroke

hemorrhage/infarct and CPM was 5.6% (8/142) and 3.5% (5/142), respectively. The extent of CPM on MRI was variable, showing a hypointensity signal of T1-weighted images in the pontine without space occupying sign (Figure 1A), and increased signal intensity of T2-weighted images in central pontine (Figure 2A, 2B) Summary: Two cases of pontine infarct with Wallerian degeneration (WD) of the pontocerebellar fibers are described. WD of pontocerebellar fibers, seen bilaterally along the transverse pontine fibers, is more visible in the middle cerebellar peduncles and extends into the white matter of the cerebellar hemispheres. Understanding the anatomy of the white matter and the temporal evolution of this.

Early Diagnosis of Central Pontine Myelinolysis with

Pontine infarct Radiology Case Radiopaedia

The investigators concluded that clinical outcome in patients with central pontine myelinolysis is not predicated on the volume of MRI T2 signal abnormalities or the severity of hyponatremia, but. Introduction. Central pontine myelinolysis (CPM) was described by Adams and colleagues in 1959 as a disease affecting alcoholics and the malnourished (Adams et al., 1959).In ∼10% patients, CPM is associated with extrapontine myelinolysis (EPM), and this may generate Parkinson symptoms (Wright et al., 1979) and psychotic features (Lim and Krystal, 2007) infarction: paramedian pontine infarcts (PPIs) and small deep pontine infarcts (SDPIs). Methods: Acute ischemic stroke patients, comprising 117 PPI patien ts and 40 SDPI patients, were enrolled. High-resolution magnetic resonance imaging (HR-MRI) and routine MRI sequenc es were performed for each patient, and clinical data were collected

Pontine infarcts form around 7% of all ischemic strokes, and isolated pontine strokes contribute to around 15% of all posterior circulation infarcts [].Mostly, they are lacunar infarcts involving basilar artery perforators and other posterior circulation small vessels [], with hypertension being a major risk factor [3, 6].MRI diffusion-weighted imaging (DWI) has been shown to have an advantage. Posted in Central Pontine Myelinolysis/ Extrapontine Myelinolysis and tagged Alzheimer's disease, brain injury, Cognition, CPM/EPM, diffusion tensor imaging, Electroencephalography, Extrapontine myelinolysis, fMRI, high definition fiber tracking, Magnetic resonance imaging, MRI Neurography, NFL, PET scan, Positron emission tomography, Post.

patients with pontine infarctions, MRI confirmed that an unilateral pontine infarction in 11 patients (8 patients in the left pons and 3 patients in the right pons) and bilateral pontine infarctions in only 1 patient (Figure 1, Table 2). All infarcts were located in the dorsal surface of the pons, with the longest diameter less than 15 mm in 4. Central pontine myelinolysis (CPM) is a clinically heterogeneous, demyelinating condition originally thought to occur only in the central pons. 7,8 When demyelination is found in areas outside of the pons, the disorder is referred to as either extrapontine myelinolysis (EPM) or central and extrapontine myelinolysis (CPEPM). 1 - 6 Identification of the importance of severe osmotic stress in. Stroke is an important differential and should be considered early. MRI head should be sought if CT head shows no acute pathologies. Multidisciplinary approach is always needed in stroke patients, with ophthalmology and orthoptic involvement for ophthalmolplegia. Horizontal gaze palsy may be the only manifestation of a pontine infarct Pontine stroke accounts for most brainstem infarcts .When a bilateral pontine or brainstem stroke occurs, it can result in an image called the heart appearance sign .Most pontine strokes are unilateral; however, approximately 10-33% of patients exhibit a bilateral acute pontine infarct .Approximately 25% of patients have a progressive course, usually within four days of the first stroke

Brainstem stroke syndromes Radiology Reference Article

On follow-up MRI performed 4 months after the onset of the involuntary tongue movements, old pontine infarct is observed, however, there is no evidence of hypertrophy of inferior olivary nucleus on T1- or T2-weighted imaging (B) Cerebral magnetic-resonance imaging showed moderate cerebellar and pontine atrophy in two patients. [childnervoussystem.blogspot.com] One patient showed distinct pontine atrophy with prominent horizontal or oblique gaze nystagmus which is an unusual feature in sporadic olivopontocerebellar atrophy Infarcts within the facial nerve nucleus or its immediate outflow tract are responsible for central lesions that present with whole-sided facial weakness and are easily misdiagnosed as peripheral lesions. Two major patterns of pontine infarcts resulting in a peripheral-type facial weakness have been recognised Her speech was slurred. Left central facial palsy and hemiglossoplegia were presented. Her left plantar response was extensor and bilateral posterior internuclear ophthalmoplegia was seen on neurologic examination. Biochemical tests revealed hyperglycemia and dyslipidemia on the next day. MRI demonstrated an acute right paramedian pontine infarct Central Pontine Myelinolysis and MRI 71 Volume 13, Issue 1, January 2014 Initial CT scan did not show any low attenuated areas. Immediate MRI of the brain was advised and requested to b

MATERIALS AND METHODS: We retrospectively reviewed cranial MR images obtained during the past seven years in our institution and selected those from patients with a chronic stage of pontine infarction and a hyperintense lesion at the central portion of the middle cerebellar peduncle on T2-weighted images Central pontine Myelinolysis (CPM) is a rare neurological disorder affecting the brain. Central pontine Myelinolysis is characterized by demyelination that is found affecting the central portion of the base of the pons. Central pontine Myelinolysis is known to be more common in adults than in children. The survival rate of people with central pontine Myelinolysis is around 94 % with the appearance of the pontine lesion on brain MRI. In the other two patients the pontine lesion was accompanied by cerebral infarction, which made it difficult to evaluate the symptoms. The most common features in all patients were hypertension with elevated blood pressure on admission and a history of diabetes mellitus (mean duration, 9.8.

Radiology 1988; 168:795-802 7. Ragland RL, Duffis AW, Gendelmal S, Sam PM, Rabinowitz JG. Central pontine myelinolysis with clinical recovery: MR documenta­ tion. J Comput Assist Tomogr 1989;13:316-318 8. Thompson PD, Miller D, Gledhill RF, Rosser MN. Magnetic resonance imaging in central pontine myelinolysis. J f'leurol f'leurosurg Psychia 1. Stroke. 2000 Mar;31(3):695-700. MRI pontine hyperintensity after supratentorial ischemic stroke relates to poor clinical outcome. Mäntylä R(1), Pohjasvaara T, Vataja R, Salonen O, Aronen HJ, Standertskjöld-Nordenstam CG, Kaste M, Erkinjuntti T Magnetic resonance imaging (MRI) has several advantages over other central nervous system imaging techniques in the posterior fossa. The usefulness of MRI in demonstrating important clinico-anatomic correlations in neuro-ophthalmologic disease of the brainstem is illustrated by a case of a pontine infarction causing abnormal horizontal gaze with preserved vertical gaze and convergence

Article - Stroke differential diagnosis and mimics: Part

We aimed to present a case of symmetrical Wallerian degeneration (WD) in the middle cerebellar peduncles (MCPs) after a unilateral paramedian pontine infarction, which was examined by multimodality magnetic resonance imaging (MRI). In addition, we summarize the small number of reported cases. In our clinic, we observed a case of symmetrical WD of bilateral MCPs that occurred 6 months after the. Central pontine myelinolysis (CPM) and extrapontine myelinolysis (EPM) are rare neurological disorders characterized by demyelination in and/or outside the pons. Whether diffusion-weighted imaging (DWI) might facilitate an earlier diagnosis has not yet been studied systematically. We describe demographics, clinical presentation, and early magnetic resonance imaging (MRI) findings with special. Central pontine myelinolysis (CPM) is a neurological disorder that most frequently occurs after too rapid medical correction of sodium deficiency (hyponatremia). The rapid rise in sodium concentration is accompanied by the movement of small molecules and pulls water from brain cells

Predictors of Dysphagia in Acute Pontine Infarctio

Pontine Stroke: Causes, Symptoms, & Treatment Flint Reha

Central pontine myelinolysis (CPM) or osmotic demyelination syndrome, as described by Adams in 1958, is a demyelinating disorder in the centre of basis pontis.1 It is characterized by rapidly progressive onset of spastic quadriplegia and pseudobulbar palsy, with progression to locked-in syndrome. Magnetic resonance imaging (MRI) of the brain. CT of the brain often fails to show the early changes of central pontine myelinolysis because it results from subtle alteration in the tissue water content, which is further obscured by artifact in this region of the brain [].However, sometimes CT shows low-attenuation changes in the pons [], as seen in our patient.MRI of the brain has greater sensitivity to the early increase in the tissue.

Central pontine myelinolysis (CPM) is a non-inflammatory demyelinating disease of the white matter tracts traversing the pons. 'Osmotic demyelination syndrome' is the preferred terminology as CPM is often associated with demyelination of other areas such as the basal ganglia, thalami and subcortical white matter MRI. The pons is diffusely enlarged encasing the basilar artery and exhibits altered signal being low in T1, slightly bright in FLAIR and very bright in T2 WIs. No diffusion restriction on DWI differentiating this lesion from acute pontine infarction Patients. Institutional review board approval was obtained for this retrospective study. Our MRI case files and radiology reports over a 15-year period (1997-2012) were compiled of patients with PRES (n = 124) as confirmed both by typical clinical symptoms, causes, and reversibility on treatment and by MRI findings that improved on follow-up MRI or CT Posted in Central Pontine Myelinolysis/ Extrapontine Myelinolysis and tagged brain injury, chemotherapy-related cognitive changes, demyelination of white matter, Dentate gyrus, diffusion tensor imaging, functional MRI (fMRI), interleukin-6 (IL-6), MR spectroscopy, neurodegenerative diseases, Neurogenesis, Neurological disorder, PET scan, post. central pontine myelinolysis. This case report underlines the importance of recognising risk factors predisposing the patient to the development of central pontine myelinolysis. Introduction Central pontine myelinolysis (CPM) is a syndrome that is characterised by rapid destruction of myelin sheaths of mainl

A brain stem stroke can also cause double vision, slurred speech and decreased consciousness. Only a half-inch in diameter, the brain stem controls all basic activities of the central nervous system: consciousness, blood pressure and breathing. All motor control for the body flows through it. Brain stem strokes can impair any or all of these. The isolated upbeat nystagmus (without rotatory component), no latency, no attenuation or resistance to Eppley maneuver are red flags that should prompt the clinician to order MRI. The presented case is the first case of central upbeat positioning nystagmus caused by pontine lacunar stroke Central Pontine Myelinolysis A 60 y o female with altered consciousness accompanying with a file of previous hospital admission and lab reports mentioning abnormal levels of Na and K. On Admission MRI T2w images show T2 hyperintensity confined to centre of Pons Central pontine myelinolysis (CPM) is an acute demyelinating neurological disorder affecting primarily the central pons and is frequently associated with rapid correction of hyponatremia. Common clinical manifestations of CPM include spastic quadriparesis, dysarthria, pseudobulbar palsy, and encephalopathy of various degrees; however, coma, locked-in syndrome, or death can. Results. Three young patients (32, 30 and 16 years old) presented with a locked-in state caused by pontine infarction. The first patient did not receive any acute stroke therapies, the second patient underwent endovascular therapy 20 hours after symptom onset resulting in partial recanalization of the basilar artery, and the third patient progressed to a locked-in state despite having received.

a Initial MRI (1 August 2003): The T2-weighted image through the pons shows a left paramedian, wedge-shaped hyperintense infarct, extending from the surface to the pontine tegmentum.b This T2-weighted image in a more caudal position does not indicate any signal changes in the middle cerebellar peduncles.c The diffusion-weighted scan shows restricted diffusion of protons in the pons, indicating. A baseline magnetic resonance imaging scan with diffusion-weighted imaging, T 1-weighted and T 2-weighted sequences showed an acute bilateral pontine infarct. On a repeat scan at 42 days, there was a 57.5% decrease in the size of the lesion on the high-resolution three-dimensional T 1 -weighted image and a corresponding improvement in the.

Autosomal dominant pontine microangiopathy and leukoencephalopathy (PADMAL) is a form of cerebral small vessel disease (cSVD) resulting in the onset of recurrent ischemic strokes in the thirties or forties. Affected individuals develop progressive, but variable, cognitive and motor impairment, consistent with progressive multi-infarct dementia Background. Central pain mimicking trigeminal neuralgia (TN) as a result of lateral medullary infarction or Wallenberg syndrome has been rarely reported. Case Report. We discuss a patient who presented with a lateral medullary infarct and shortly after developed facial pain mimicking TN. We also elaborate on the anatomical pathway of the trigeminal nerve explaining facial pain as a result of a. Posterior reversible encephalopathy syndrome (PRES) is a cliniconeuroradiological syndrome characterised by a unique reversible pattern on imaging and total regression of clinical symptoms and signs. We describe an unusual case of PRES with isolated pontine involvement with coincidental acute ischaemic stroke in a 60-year-old man who presented with headache, unsteadiness of gait, blurred.

Cases of isolated pontine oedema making the diagnosis more challenging have also been reported.3 6 7 Pontine oedema associated with hypertension can mimic central pontine myelinolysis. The differential diagnosis of pontine high signal changes on MRI includes also neoplastic causes such as glioma as well as inflammatory causes such as ADEM and. Central pontine myelinolysis. Osmotic demyelination syndrome (ODS) is brain cell dysfunction. It is caused by the destruction of the layer ( myelin sheath) covering nerve cells in the middle of the brainstem (pons). The central nervous system comprises the brain and spinal cord. The peripheral nervous system includes all peripheral nerves Tel +81-45 787 2800. Email fumihiro@yokohama-cu.ac.jp. Abstract: Central pontine myelinolysis (CPM) is a rare demyelinating condition which has been reported to occur in a variety of clinical settings, but most commonly in association with a rapid rise in plasma osmolality during correction of chronic hyponatremia Yes: Now called osmotic demyelination syndrome, it is a neurological disease caused by severe damage of the myelin sheath of nerve cells in the brainstem and sometimes outside the brainstem. It can be caused by rapid correction of low serum sodium.Less commonly, it may also present in patients with a history of chronic alcoholism or other conditions related to decreased liver function Medial medullary syndrome, also known as inferior alternating syndrome, hypoglossal alternating hemiplegia, lower alternating hemiplegia, or Dejerine syndrome, is a type of alternating hemiplegia characterized by a set of clinical features resulting from occlusion of the anterior spinal artery.This results in the infarction of medial part of the medulla oblongat

MRI can also help distinguish basilar branch infarcts from small artery strokes (48; 136; 14). Basilar branch infarcts tend to produce unilateral ventral pontine infarcts, often larger than 1.5 cm, that extend to the pontine surface A, B. DWI and T2WI shows hyperintense lesions in the right cerebellar hemisphere and the left side of the pons at 10 days after onset, which represents subacute hemorrhagic infarcts. C, D. On follow-up MRI at 8 months after onset, old infarcts show very high intensity on T2WI and low intensity on FLAIR image as CSF

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