title: Midbrain ischemia presenting as vertical gaze palsy: value of diffusion-weighted magnetic resonance imaging.
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. T(2)-weighted and FLAIR imaging failed to identify the clinically relevant lesion in 2 and 3 patients, respectively.
  
  
  CONCLUSIONS
  DWI improves the clinicoanatomical correlation in patients presenting with supranuclear oculomotor disturbances.
authors.affiliation: Department of Neurology, Karl Franzens University, Graz, Austria. thomas.seifert@uni-graz.at
authors.forename: T
authors.initials: T
authors.lastname: Seifert
authors.forename: C
authors.initials: C
authors.lastname: Enzinger
authors.forename: S
authors.initials: S
authors.lastname: Ropele
authors.forename: M K
authors.initials: MK
authors.lastname: Storch
authors.forename: F
authors.initials: F
authors.lastname: Fazekas
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D002545:Brain Ischemia / Q000150:complications* / Q000175:diagnosis*; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D008297:Male; D008636:Mesencephalon / Q000098:blood supply*; D009886:Ophthalmoplegia / Q000209:etiology*