The Medial Pontine Mid-Tegmentum Syndrome

J Stroke Cerebrovasc Dis. 2020 Jun;29(6):104750. doi: 10.1016/j.jstrokecerebrovasdis.2020.104750. Epub 2020 Mar 24.

Abstract

Isolated pontine infarcts are common and are often associated with well-described syndromes that are classified based on their specific clinical presentation and arterial stroke territories. Here we present a case of acute combined diplopia and unilateral lower extremity sensory abnormality. Diffusion-weighted magnetic resonance imaging revealed a punctate area of acute ischemia in the right medial pontine mid-tegmentum. These findings suggest a unique pontine stroke syndrome characterized by acute ischemic injury at the intersection of the medial lemniscus and cranial nerve VI.

Keywords: Infarction; basilar artery; isolated pontine syndrome; magnetic resonance imaging; pons; sixth nerve palsy.

Publication types

  • Case Reports

MeSH terms

  • Abducens Nerve Diseases / diagnosis
  • Abducens Nerve Diseases / etiology*
  • Abducens Nerve Diseases / physiopathology
  • Brain Stem Infarctions / complications*
  • Brain Stem Infarctions / diagnostic imaging
  • Brain Stem Infarctions / physiopathology
  • Diffusion Magnetic Resonance Imaging
  • Diplopia / diagnosis
  • Diplopia / etiology*
  • Diplopia / physiopathology
  • Female
  • Humans
  • Lower Extremity / innervation*
  • Middle Aged
  • Pontine Tegmentum / blood supply*
  • Pontine Tegmentum / diagnostic imaging
  • Predictive Value of Tests
  • Sensation Disorders / diagnosis
  • Sensation Disorders / etiology*
  • Sensation Disorders / physiopathology
  • Syndrome