Brainstem lesions: MRI review of standard morphological sequences
Dimitri Renard1, Jean-Sebastien Guillamo2, Ioana Ion2
1Department of Neurology, CHU Nîmes, Hôpital Carémeau, University of Montpellier, 4 Rue du Professeur Debré, 30029, Nîmes Cedex 9, France. dimitrirenard@hotmail.com.
Abstract:
MRI signal changes in the brainstem are observed in a multitude of disorders including vascular diseases, neoplastic lesions, degenerative diseases, inflammatory disorders, metabolic diseases, infections, and trauma. In some diseases, brainstem involvement is typical and sometimes isolated, while in other diseases, brainstem lesions are only observed occasionally in the presence of other typical extra-brainstem abnormalities. In this review, we will discuss the MRI characteristics of brainstem lesions observed in different disorders associated with frequent and less frequent brainstem involvement. Identification of the origin of the brainstem lesion depends on the exact localisation of the lesion(s) inside the brainstem, the presence and the characteristics of associated lesions seen outside the brainstem, the signal changes on different MRI sequences, the evolution over time of the radiological abnormalities, the history and clinical state of the patient, and other radiological and non-radiological examinations.
Insights
This review details MRI findings in brainstem lesions across various conditions. Understanding lesion characteristics and patient history is key to diagnosing the cause of brainstem abnormalities.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Brainstem lesions are indicative of numerous conditions, including vascular, neoplastic, degenerative, inflammatory, metabolic, infectious, and traumatic disorders.
- Brainstem involvement can be a primary feature or an incidental finding alongside other abnormalities.
Purpose of the Study:
- To review and discuss the magnetic resonance imaging (MRI) characteristics of brainstem lesions.
- To differentiate between disorders with typical and occasional brainstem involvement based on MRI findings.
Main Methods:
- Review of existing literature on MRI findings in brainstem lesions.
- Analysis of MRI signal changes, lesion localization, and associated abnormalities.
Main Results:
- MRI characteristics vary significantly depending on the underlying disorder affecting the brainstem.
- Accurate diagnosis relies on precise lesion localization within the brainstem and evaluation of associated extra-brainstem findings.
Conclusions:
- The precise localization of lesions within the brainstem is crucial for diagnosis.
- Integrating MRI signal changes, lesion evolution, clinical history, and other examinations aids in identifying the cause of brainstem lesions.
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