Rinsho Shinkeigaku (Clinical Neurology)

Case Report

A case of midbrain infarction with acute bilateral cerebellar ataxia visualized by diffusion tensor imaging

Yuka Maya, M.D.1)3), Masahito Kawabori, M.D., Ph.D.1), Daisuke Oura, A.S.2), Yoshimasa Niiya, M.D., Ph.D.1), Motoyuki Iwasaki, M.D., Ph.D.1) and Shoji Mabuchi, M.D., Ph.D.1)

1)Department of Neurosurgery, Otaru General Hospital
2)Department of Radiology, Otaru General Hospital
3)Department of Dermatology, Hokkaido University Graduate School of Medicine

An 85-year-old woman with hypertension was admitted with a sudden onset of gait disturbance and dysarthria. On admission, the patient showed severe bilateral cerebellar ataxia with moderate right medial longitudinal fasciculus (MLF) syndrome. Magnetic resonance (MR) imaging showed an acute infarction in the lower and medial part of midbrain. Diffusion tensor imaging (DTI) started from both cerebellar peduncles revealed that the lesion of the acute infarction matched the decussation of superior cerebellar peduncle where crossing of tract was seen and a part of its tract was interrupted at the site. Interruption of the cerebellum red nuclear path at the medial part of midbrain was considered to be the reason for bilateral cerebellar ataxia and visualization of cerebellum red nuclear path by DTI can give better understanding of the neurological symptom.
Full Text of this Article in Japanese PDF (413K)

(CLINICA NEUROL, 56: 565|568, 2016)
key words: bilateral cerebellar ataxia, midbrain infarction, diffusion tensor imaging, decussation of superior cerebellar peduncles

(Received: 12-May-16)