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case_images: Plain brain magnetic resonance imaging (MRI) of brainstem tumor (T2-weighted images). Brain MRI at the initial examination revealed a mass in the brainstem with high-signal intensity on T2-weighted images (a). MRI after radiotherapy revealed that the tumor had shrunk (b). MRI in the year X - 1 showed that the necrotic changes below T2-hyperintensity increased. Extension of the left internal capsule toward the hindlimb increased (c). According to the MRI in the year X, the necrotic change at the bottom of the T2-hyperintense area further increased, and the tumor was enlarged (d).
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case_images: PMC11700401_01_10.1177_11795476241311528-fig1.jpg
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case_images: The course of pain and rehabilitation treatment.. Abbreviations: NRS, numerical rating scale; ROM, range-of-motion; SFMPQ-2, short-form McGill pain questionnaire-2.
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case_images: Immediately before botulinum administration, the NRS score was 7.5, the short-form McGill pain questionnaire (SFMPQ)-2 score was 119, and scores for intermittent and neuropathic pain were high (Figure 2).   Initial treatment with 200 units of botulinum intramuscularly administered in the upper arm and thigh, where pain was most severe, resulted in improvement in the NRS and SFMPQ-2 scores to 6.0 and 78, respectively, after a period of 2 weeks.