Original Paper

Midbrain Ischemia Presenting as Vertical Gaze Palsy: Value of Diffusion-Weighted Magnetic Resonance Imaging
T. Seifert^a, C. Enzinger^a, S. Ropele^a,b, M.K. Storch^a, F. Fazekas^a,b

Departments of
^aNeurology and
^bMRI Center, Karl Franzens University, Graz, Austria

Address of Corresponding Author

Cerebrovasc Dis 2004;18:3-7 (DOI: 10.1159/000078601)

  Key Words

• Diffusion-weighted imaging
• Midbrain ischemia
• Vertical gaze palsy

  Abstract

Background: Conventional magnetic resonance imaging may fail to identify very small but clinically relevant acute subcortical brain infarcts. Diffusion-weighted magnetic resonance imaging (DWI) is very sensitive and specific for acute cerebral ischemia and should contribute to the early detection of such lesions. Methods: We analyzed 6 patients who presented with acute vertical gaze palsy and in whom DWI was performed within 1-6 days from symptom onset. Results: DWI accurately identified ischemia in an area supplied by the posterior thalamosubthalamic paramedian artery in all patients. T₂-weighted and FLAIR imaging failed to identify the clinically relevant lesion in 2 and 3 patients, respectively. Conclusion: DWI improves the clinicoanatomical correlation in patients presenting with supranuclear oculomotor disturbances.

Copyright © 2004 S. Karger AG, Basel

  Author Contacts

Thomas Seifert, MD
Department of Neurology, Karl Franzens University
Auenbruggerplatz 22
AT-8036 Graz (Austria)
Tel. +43 316 385 81784, Fax +43 316 32 55 20, E-Mail thomas.seifert@uni-graz.at

  Article Information

Received: September 16, 2003
Accepted: November 17, 2003
Published online: May 19, 2004
Number of Print Pages : 5
Number of Figures : 2, Number of Tables : 1, Number of References : 25