case_images: PMC10188972_01
case_images: Cerebral magnetic resonance imaging (T2-flair) performed at day one showing three demyelinating in the brainstem.
case_images: fcvm-10-1175644-g001.jpg
case_images: PMC10188972_01_fcvm-10-1175644-g001.jpg
case_images: F1
case_images: Cerebral MRI revealed multiple demyelinating lesions, three of which were located in the brainstem (Figure 1: Cerebral magnetic resonance imaging (T2-flair) performed at day one showing three demyelinating in the brainstem).
case_images: Electrocardiogram performed at day 1 revealing ST-segment depression in the inferior (II-III-aVF) and precordial (V3 through V6) leads.
case_images: fcvm-10-1175644-g002.jpg
case_images: PMC10188972_01_fcvm-10-1175644-g002.jpg
case_images: F2
case_images: An ECG showed ST-segment depression in the inferior (II-III-aVF) and precordial (V3 through V6) leads (Figure 2: Electrocardiogram performed at day 1 revealing ST-segment depression in the inferior (II-III-aVF) and precordial (V3 through V6) leads).
case_images: Transthoracic echocardiography performed at day one, showing a severely reduced left ventricular ejection fraction (24%) with basal and midventricular segments akinesia, and preserved apical contraction. There was no significant valvulopathy and right ventricular function was normal. A: Diastole, B: Systole.
case_images: fcvm-10-1175644-g003.jpg
case_images: PMC10188972_01_fcvm-10-1175644-g003.jpg
case_images: F3
case_images: TTS, with basal and mid-ventricular segments akinesia and a spared apical contractility (Figure 3: Transthoracic echocardiography performed at day one, showing a severely reduced left ventricular ejection fraction (24%) with basal and midventricular segments akinesia, and preserved apical contraction. There was no significant valvulopathy and right ventricular function was normal.
case_images: Cardiac MRI images from T2-mapping revealing myocardial oedema in four, three and two-chamber views.
case_images: fcvm-10-1175644-g004.jpg
case_images: PMC10188972_01_fcvm-10-1175644-g004.jpg
case_images: F4
case_images: Horizontal long-axis, color-coded images from T2-mapping revealed hyperintensity in the basal and mid-ventricular segments of the left ventricle that confirmed the presence of regional circumferential myocardial oedema (Figure 4: cardiac MRI images from T2-mapping revealing myocardial oedema in four, three and two-chamber views), as well as the absence of late gadolinium enhancement (supporting the idea that there was no irreversible myocardial injury).
case_images: Absence of irreversible tissue injury (late gadolinium enhancement) in four, three and two-chamber views.
case_images: fcvm-10-1175644-g005.jpg
case_images: PMC10188972_01_fcvm-10-1175644-g005.jpg
case_images: F5
case_images: All these elements were in favor of a final diagnosis of reverse TTS triggered by brainstem lesions of MS (Figure 5: absence of irreversible tissue injury (late gadolinium enhancement) in four, three and two-chamber views).