A case of bilateral middle cerebellar peduncle infarction with hot cross bun sign

A 71-year-old man with hypertension and diabetes mellitus presented to our hospital because he felt lightheaded. Diffusion-weighted images (DWI) on brain MRI showed high signal lesions in the left cerebellar hemisphere and the right pons. The diagnosis of cerebellar infarction was made, but he refused treatment. One month later, he came to our hospital because his body leaned to the left. Neurological examination revealed dysarthria and cerebellar truncal ataxia. An electrocardiogram showed atrial fibrillation. DWI on brain MRI showed high signal lesions in the bilateral cerebellar hemispheres and middle cerebellar peduncles (MCP). Dabigatran 300 ‍mg/day was administered for cardiogenic cerebral embolism. On the 12th day of onset, he was transferred to a rehabilitation hospital. At 72 years old, T2*-weighted images on brain MRI showed hot cross bun sign (HCBs) in the pons. We considered that HCBs were caused by antegrade or retrograde degeneration (or both) of pontine infarcts and bilateral MCP infarcts in the pontine cerebellar tract. It seemed preferable to use T2*-weighted images or proton density-weighted images rather than T2-weighted images to detect HCBs. When HCBs is detected, it should be noted that HCBs can be caused by bilateral MCP infarcts in addition to multiple system atrophy.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:64

Enthalten in:

Rinsho shinkeigaku = Clinical neurology - 64(2024), 3 vom: 22. März, Seite 190-193

Sprache:

Japanisch

Beteiligte Personen:

Kuzume, Daisuke [VerfasserIn]
Morimoto, Yuko [VerfasserIn]
Tsutsumi, Satoshi [VerfasserIn]
Yamasaki, Masahiro [VerfasserIn]
Hosomi, Naohisa [VerfasserIn]

Links:

Volltext

Themen:

Bilateral middle cerebellar peduncle
Cardiogenic infarction
Case Reports
English Abstract
Hot cross bun sign
Journal Article

Anmerkungen:

Date Completed 26.03.2024

Date Revised 26.03.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.5692/clinicalneurol.cn-001897

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM368593894