title: Utility of High-b-Value Diffusion-Weighted Magnetic Resonance Imaging in Evaluating Reversible Medial Longitudinal Fasciculus Syndrome Caused by Acute Brainstem Ischemia.
abstract: BACKGROUND
  Medial longitudinal fasciculus (MLF) syndrome refers to a gaze disorder characterized by impaired adduction on the ipsilateral side to the injured MLF, with dissociated nystagmus of the contralateral abducting eye. The most common cause of the MLF syndrome is ischemic stroke. However, acute ischemic change in the MLF may be undetectable even on diffusion-weighted magnetic resonance imaging (DW-MRI) partly because of its small size and specific brainstem location.
  
  
  METHODS
  Herein, we present the first reported case of MLF syndrome in which, compared with the standard-b-value DWI, a higher b-value DWI revealed more clearly a small infarction in the dorsal pons in the acute stage.
  
  
  CONCLUSIONS
  We suggest that high-b-value DWI can be a useful diagnostic method for patients with MLF syndrome caused by possible brainstem ischemia and thus supportive for deciding the optimal treatment for such patients.
authors.affiliation: Department of Neurosurgery, Stroke Center, Osaka Wakakusa Dai-ichi Hospital, Osaka, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Miki
authors.affiliation: Department of Neurosurgery, Stroke Center, Osaka Wakakusa Dai-ichi Hospital, Osaka, Japan. Electronic address: mfujioka_2000_99@yahoo.co.jp.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Fujioka
authors.affiliation: Department of Radiology, Nara Medical University, Nara, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Taoka
authors.affiliation: Department of Neurosurgery, Stroke Center, Osaka Wakakusa Dai-ichi Hospital, Osaka, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Tanaka
authors.affiliation: Department of Neurosurgery, Stroke Center, Osaka Wakakusa Dai-ichi Hospital, Osaka, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Chitoku
authors.affiliation: Department of Neurosurgery, Stroke Center, Osaka Wakakusa Dai-ichi Hospital, Osaka, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Matsuyama
authors.affiliation: Department of Radiology, Osaka Wakakusa Dai-ichi Hospital, Osaka, Japan.
authors.forename: Shigeko
authors.initials: S
authors.lastname: Tanaka
mesh_terms: D002545:Brain Ischemia / Q000150:complications* / Q000473:pathology; D001933:Brain Stem / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D009759:Nystagmus, Pathologic / Q000209:etiology* / Q000473:pathology
keywords: MLF syndrome; MRI; brainstem; high-b-value DWI; stroke