case_images: PMC9082153_01
case_images: a-b MRI performed 12 h after symptom onset. a Diffusion-weighted MRI with a 128 x 128 matrix, a 5-mm thickness, and a 1.5-mm gap showing hyperintensity in the right paramedian area of the midbrain (white arrows). b The lesion had a low ADC value. c-h MRI performed 20 days after onset. T2-MRI axial sections (c-f) and frontal sections (g-h) with a 384 x 384 matrix, a 3-mm section thickness, and a 0.9-mm gap revealed an infarct of the paramedian midbrain region located rostrocaudally from the superior colliculus level to the caudal border of the midbrain (white arrows). ADC, apparent diffusion coefficient.
case_images: crn-0014-0197-g01.jpg
case_images: PMC9082153_01_crn-0014-0197-g01.jpg
case_images: F1
case_images: Diffusion-weighted magnetic resonance imaging (MRI) of the brain performed 12 h after symptom onset showed a high-intensity lesion in the right paramedian region of the midbrain (Fig. 1a), and the lesion had a low apparent diffusion coefficient value (Fig. 1b). On day 20 of hospitalization, T2-weighted MRI revealed an infarct of the paramedian midbrain region 13 mm in length in the ventrodorsal direction, from the substantia nigra to the cerebral aqueduct, and 9 mm in length in the rostrocaudal direction, from the superior colliculus level to the caudal border of the midbrain (Fig. 1c-h).