Brain Stem Hypertensive Encephalopathy Evaluated by Line Scan Diffusion-Weighted Imaging
Motonori Nagataa,
Masayuki Maedaa,b,c,
Hirokazu Tsukaharab,
Stephan E. Maierc and
Ken Takedaa
a Department of Radiology, Mie University School of Medicine, Tsu, Mie, Japan
b Department of Pediatrics, Fukui Medical University, Matsuoka, Fukui, Japan
c Department of Radiology, Brigham & Women’s Hospital, Boston, MA
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FIG 1. Initial MR images obtained in a 67-year-old man with hypertension.
A, B, Fast FLAIR images show an extensive brain stem lesion. The dentate nucleus is also involved.
C, Fast FLAIR image shows periventricular hyperintensities.
D, Trace LSDWI (b = 1000 s/mm2) shows isointensity in the brain stem.
E, Corresponding ADC map shows increased diffusion in the brain stem lesions (1.04 ± 0.04 x 10–3 mm2/s), indicating vasogenic edema.
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FIG 2. Follow-up MR images 2 weeks after initial MR imaging.
A and B, Fast FLAIR images show complete resolution of the brain stem and cerebellar lesions.
C, Fast FLAIR image shows that the periventricular hyperintensities decrease to some degree.
D, ADC map appears normal. The ADC of the brain stem is 0.84 ± 0.02 x 10–3 mm2/s.
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