CASE OF THE MONTH

2003

ANSWER

FOR Sep

Fig 1
Figure 1. Axial T1 weighted image (day 3)

Fig 2
Figure 2. Axial T2 weighted image (day 3)

Fig 3
Figure 3. Axial ADC image (day 3)

There is a T1 hypointense (figure 1), T2 hyperintense lesion (figure 2) in the midbrain with decreased ADC value (figure 3) typical of an acute or subacute brainstem infarct. Subacute haemorrhage (day 3) show hyperintensity in T1 weighted image due to methaemoglobin. Chronic midbrain infarct, multiple sclerosis and acute osmotic myelinolysis show elevated ADC values.

DIAGNOSIS :

Subacute brainstem infarct

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