Caption: FIGURE 1: Axial T2-FLAIR MRI showing interval increase of leptomeningeal enhancement and hyperintense signal involving the left middle cerebral peduncle
, cerebellar vermis, and bilateral cerebellar hemisphere.
T1-weighted images (T1WI) demonstrated the lesion mainly involving the central portion of the cerebral peduncle
with low signal intensity (Figure 1(c)).
If the midbrain is shifted against the contralateral margin (free edge) of the tentorium, the cerebral peduncle
on that side may be compressed, resulting in a hemiparesis which is ipsilateral to the supratentorial lesion (and hence may be considered 'false-localising').
"Using animal models of TBI, our study investigated the prolonged pathological outcomes of TBI in different parts of the brain, such as the dorsal striatum, thalamus, corpus callosum white matter, hippocampus and cerebral peduncle
," Borlongan, the study's lead author, said.
Examples include complete 3rd nerve palsy accompanied by contralateral limb ataxia and tremor from involvement of the red nucleus (Claude syndrome) or by contralateral hemiparesis from involvement of descending motor (eg cortico-spinal) axons in the cerebral peduncle
(Weber syndrome) or in combination with both types of motor disorder affecting the opposite limb(s) (Benedict syndrome).
One could also identify the upper part of the cerebral peduncle
Mild atrophy was seen in ipsilateral cerebral peduncle
, thalamus, and contralateral cerebellar hemisphere.
The radiologist reported findings that are representative of multiple sclerosis, with involvement of the right cerebral peduncle
, left middle cerebellar peduncle, medulla oblongata, anterior brainstem at the level of the pontomedullary sulcus in the region of the VI cranial nerve origins, and within the upper cervical cord.
If the penetrating branches are occluded, the thalamus, cerebral peduncle
, and/or brainstem may be involved (Hickey, 1992) (see Table 2).
On MRI brain (plain), there was a large(size) well defined cystic mass in right temporo-parieto-occipital region with mild vasogenic oedema and mass effects causing midline shift, compression of ipsilateral lateral and third ventricle and cerebral peduncle