case_images: PMC11185004_01
case_images: (A) During vHIT (2022-01-13 19:20), shows decreased abnormal saccade waves and head impulse gain of the vestibulo-ocular reflex for the horizontal, anterior, and posterior semicircular canals. (B) Figure shows bilateral gaze-evoked nystagmus and upbeat nystagmus. (C) During SHIMP (2022-01-13 19:25), shows only very few downward saccades reflecting anti-compensatory saccades after the end of the head impulse back to the head-fixed target and decreased vestibulo-ocular reflex gain values of the bilateral semicircular canals.. Abbreviations: AC, anterior canal; H, horizontal position of the left eye; HC, horizontal canal; PC, posterior canal; SHIMP, suppression head impulse paradigm; V, vertical position of the left eye.
case_images: 10.1177_11795476241262213-fig1.jpg
case_images: PMC11185004_01_10.1177_11795476241262213-fig1.jpg
case_images: fig1-11795476241262213
case_images: Notably, suppression head impulse paradigm (SHIMP) further confirmed the decreases in the gain values of the bilateral semicircular canals (Figure 1).
case_images: Fiugre shows left medulla oblongata DWI high signal (A), low ADC signal (B).
case_images: 10.1177_11795476241262213-fig2.jpg
case_images: PMC11185004_01_10.1177_11795476241262213-fig2.jpg
case_images: fig2-11795476241262213
case_images: ADC signal (Figure 2), and no obvious abnormality on MRA. According to these imaging findings, the patient was considered to have left medulla infarction.