We measured the areas of the pontine base, the pontine
tegmentum, the cerebellar vermis and the posterior fossa [Figure 4] on midsagittal images demonstrating the cerebral aqueduct clearly from 7 SCA3/MJD patients.
Colour of
tegmentum very variable, whitish with pale brown and black flecks, greenish with darker flecks mainly on jugal areas, evenly reddish brown, or marbled with irregular spots of various colours.
The site of the lesion is usually in the basis pontis and there may be variable involvement of the pontine
tegmentum, medulla and midbrain.
Our data indicated that at least one of the brain sites for memantine effects on corticosterone may be the ventral
tegmentum area.
Brain MRI showed hyperintense lesions in the
tegmentum of the medulla oblongata, pons, and midbrain in T2-weighted and fluid attenuated inversion recovery images (Figure 1).
His MRI Brain done on Day 3 of admission revealed the following interesting finding: Hyperintense signal change in pons with partial sparing of the
tegmentum, ventrolateral pons and corticospinal tracts on FLAIR (Fig.
Neuromodulatory systems in the basal forebrain and midbrain
tegmentum are widely believed to be activated by tasks requiring attention and serve to make neurons more sensitive to their afferent input [2].
IMAGING FINDINGS: Axial T2 FLAIR image reveals a symmetric hyperintensity involving the central pontine region, sparing the
tegmentum and cortico spinal tracts resulting in a characteristic Mexican hat or bat wing configuration of hyperintensity.
It has also been detected at varying degrees in the spinal cord, medulla, pons,
tegmentum and hypothalamus [15,16,56].
The front of it encloses a cavity, as in the third ventricle, and at dorsal portion of the mesencephalon is the tectum, at the
tegmentum is ventrally.
The descending pain pathways consist of the midbrain periaqueductal gray area (PGA), the rostroventral medulla (RVM), and the dorsolateral pontomesencephalic
tegmentum (DLPT).