Presentation
Sudden onset of slurred speech and decreased level of consciousness.
Patient Data
Age: 40 years
Gender: Female
From the case:
Wernekinck commissure syndrome
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DWI shows diffusion restriction in the bilateral paramedian region with a high signal in the tegmentum of the caudal midbrain in the FLAIR sequence demonstrating a V or heart-shaped appearance.
Case Discussion
Neurological examination revealed bilateral internuclear ophthalmoplegia, severe dysarthria, and gait ataxia. Heel-to-shin tests on both sides detected marked motor incoordinations and severe dysmetria.
Features are consistent with an acute midbrain infarct resulting in Wernekink commissure syndrome.
Fortunately, the patient became fully conscious after 7 days.
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