Maya Yuka, Kawabori Masahito, Oura Daisuke, Niiya Yoshimasa, Iwasaki Motoyuki, Mabuchi Shoji
Department of Neurosurgery, Otaru General Hospital.
Rinsho Shinkeigaku. 2016 Aug 31;56(8):565-8. doi: 10.5692/clinicalneurol.cn-000909. Epub 2016 Jul 29.
An 85-year-old woman with hypertension was admitted with a sudden onset of gait disturbance and dysarthria. On admission, the patient showed severe bilateral cerebellar ataxia with moderate right medial longitudinal fasciculus (MLF) syndrome. Magnetic resonance (MR) imaging showed an acute infarction in the lower and medial part of midbrain. Diffusion tensor imaging (DTI) started from both cerebellar peduncles revealed that the lesion of the acute infarction matched the decussation of superior cerebellar peduncle where crossing of tract was seen and a part of its tract was interrupted at the site. Interruption of the cerebellum red nuclear path at the medial part of midbrain was considered to be the reason for bilateral cerebellar ataxia and visualization of cerebellum red nuclear path by DTI can give better understanding of the neurological symptom.
一名85岁高血压女性因突然出现步态障碍和构音障碍入院。入院时，患者表现为严重的双侧小脑共济失调及中度右侧内侧纵束（MLF）综合征。磁共振（MR）成像显示中脑下部和内侧急性梗死。从双侧小脑脚开始的弥散张量成像（DTI）显示，急性梗死灶与小脑上脚交叉部位相符，在此可见纤维束交叉，且部分纤维束在此部位中断。中脑内侧小脑红核通路中断被认为是双侧小脑共济失调的原因，而DTI显示的小脑红核通路有助于更好地理解神经症状。
