Diffusion-weighted imaging as an aid in the diagnosis of the etiology of medial longitudinal fasciculus syndrome.
OBJECTIVE
Internuclear ophthalmoplegia is caused by a lesion; stroke, multiple sclerosis, brain metastases, or trauma may produce lesions of the medial longitudinal fasciculus (MLF). Imaging techniques, such as DWI, can help identify the site of the lesion in order to speed diagnosis and lead to appropriate treatment.


METHODS
Over an 8-month period, eight consecutive patients with suspected MLF syndrome (most secondary to ischemic stroke) underwent MRI examinations, including DWI sequencing, at an academic center in Taiwan.


RESULTS
In all eight patients, abnormal high-signal lesions were found close to the floor of the fourth ventricle on the dorsal side of the pons. A neuroanatomical comparison showed that the location of the lesions was identical to the anatomical position of the MLF.


CONCLUSIONS
Using DWI, good clinico-radiological correlation was found in all eight ischemic stroke patients diagnosed with MLF syndrome. DWI may broaden the application of MRI in the diagnosis of MLF syndrome.
Department of Diagnostic Radiology, National Cheng Kung University Hospital, No. 138 Sheng-Li Rd, Tainan, 704, Taiwan.
Ming-Tsung
MT
Chuang
Chou-Ching
CC
Lin
Pi-Shan
PS
Sung
Hui-Chen
HC
Su
Ying-Chen
YC
Chen
Yi-Sheng
YS
Liu
D000368:Aged; D000369:Aged, 80 and over; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015835:Ocular Motility Disorders / Q000175:diagnosis* / Q000209:etiology* / Q000473:pathology; D012189:Retrospective Studies; D020521:Stroke / Q000150:complications* / Q000473:pathology; D013577:Syndrome; D013624:Taiwan