Injury caused by adults of Heilus freyreissi on branches (A, B), avocado central leaf vein (C), inflorescence (D), peduncle
(E), and fruit (F).
Neuroanatomically, MCPs, also known as the pontibrachium, are the largest peduncles
connecting the brainstem to the cerebellum.
His brain MRI showed atrophy of pons, medulla and cerebellum, and high signals in pons and middle cerebellar peduncle
with cruciform pontine hyperintensity (hot cross bun sign) on axial T2W image (Figure-1).
Chest X-ray showing cardiomegaly (Figure 3), ultrasonography abdomen suggestive of 5 x 3 mm small medullary cyst in the lower pole of right kidney, and 6 x 5 mm small medullary cyst in the lower pole of left kidney.MRI brain showing prominent and elongated cerebellar peduncle
with dysplastic vermis giving " Molar tooth appearance" (Figure 4).
T1-weighted images (T1WI) demonstrated the lesion mainly involving the central portion of the cerebral peduncle
with low signal intensity (Figure 1(c)).
Infratentorial involvement is characterized by T2 hyperintensity in the cerebellar white matter and peduncles
. Three distinct stages of illness are recognized, with ataxia and dysarthria being common initial presenting signs.
Nine descriptors were applied to determine the quantitative aspects: plant height; leaf length; leaf width; peduncle
diameter, syncarp length, syncarp diameter; crown length and crown diameter.
Signal changes in cerebellar peduncles
(Pattern 5) are seen in 2 cases of Wilson's disease, 1 case of ataxia and atypical Parkinson's disease.
The most basal cauline leaf in the proximal third of the stem, 25-54 x 0.3-1 cm, at the base sheathing the base of the stem; the upper leaves gradually smaller, the most distal bracteiform, ovate-lanceolate, 1.5-3.5 x 0.5-1 cm, at the base sheathing the basal part of the peduncles
. Flowering stems 40-85 cm long, with 2-5 branches in the distal third.
It is readily distinguished from those species, and from all other species of Heteropterys, by the following combination of characters: small nearly glabrous leaves with large glands on the abaxial surface (not on the margin), epipetiolar stipules, umbels or corymbs of 4-6 flowers, well-developed peduncles
with the bracteoles borne near the base, and tiny greenish petals.
elliptic-ovate) leaves, very long peduncles
Diffusion tensor tractography confirms the failure of superior cerebellar peduncle