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Focal T2 hyperintense brainstem lesion

MedGen UID:
868354
•Concept ID:
C4022748
•
Finding
HPO: HP:0012748

Definition

A lighter than expected T2 signal on magnetic resonance imaging (MRI) of the brainstem. This term refers to a localized hyperintensity affecting a particular region of the brainstem. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVFocal T2 hyperintense brainstem lesion

Professional guidelines

PubMed

Differential diagnosis of T2 hyperintense brainstem lesions: Part 1. Focal lesions.
Guzmán-De-Villoria JA, Fernández-García P, Ferreiro-Argüelles C
Semin Ultrasound CT MR 2010 Jun;31(3):246-59. doi: 10.1053/j.sult.2010.03.001. PMID: 20483392
Tectal gliomas in children: the implications for natural history and management strategy.
Dağlioğlu E, Cataltepe O, Akalan N
Pediatr Neurosurg 2003 May;38(5):223-31. doi: 10.1159/000069823. PMID: 12686764
The management of brainstem gliomas in patients with neurofibromatosis 1.
Pollack IF, Shultz B, Mulvihill JJ
Neurology 1996 Jun;46(6):1652-60. doi: 10.1212/wnl.46.6.1652. PMID: 8649565

Recent clinical studies

Etiology

Clinical characteristics of myelin-oligodendrocyte glycoprotein antibody-positive pediatric autoimmune encephalitis without demyelination: A case series.
Song X, Ma J
Front Immunol 2022;13:1050688. Epub 2022 Dec 1 doi: 10.3389/fimmu.2022.1050688. PMID: 36532000Free PMC Article
Imaging Patterns Characterizing Mitochondrial Leukodystrophies.
Roosendaal SD, van de Brug T, Alves CAPF, Blaser S, Vanderver A, Wolf NI, van der Knaap MS
AJNR Am J Neuroradiol 2021 Jul;42(7):1334-1340. Epub 2021 Apr 1 doi: 10.3174/ajnr.A7097. PMID: 34255734Free PMC Article
Hypertrophic olivary degeneration following pontine haemorrhage: hypertensive crisis or cavernous haemangioma bleeding?
Krings T, Foltys H, Meister IG, Reul J
J Neurol Neurosurg Psychiatry 2003 Jun;74(6):797-9. doi: 10.1136/jnnp.74.6.797. PMID: 12754356Free PMC Article
MR imaging of the central nervous system in diving-related decompression illness.
Reuter M, Tetzlaff K, Hutzelmann A, Fritsch G, Steffens JC, Bettinghausen E, Heller M
Acta Radiol 1997 Nov;38(6):940-4. doi: 10.1080/02841859709172107. PMID: 9394646
The management of brainstem gliomas in patients with neurofibromatosis 1.
Pollack IF, Shultz B, Mulvihill JJ
Neurology 1996 Jun;46(6):1652-60. doi: 10.1212/wnl.46.6.1652. PMID: 8649565

Diagnosis

Imaging Patterns Characterizing Mitochondrial Leukodystrophies.
Roosendaal SD, van de Brug T, Alves CAPF, Blaser S, Vanderver A, Wolf NI, van der Knaap MS
AJNR Am J Neuroradiol 2021 Jul;42(7):1334-1340. Epub 2021 Apr 1 doi: 10.3174/ajnr.A7097. PMID: 34255734Free PMC Article
Differential diagnosis of T2 hyperintense brainstem lesions: Part 1. Focal lesions.
Guzmán-De-Villoria JA, Fernández-García P, Ferreiro-Argüelles C
Semin Ultrasound CT MR 2010 Jun;31(3):246-59. doi: 10.1053/j.sult.2010.03.001. PMID: 20483392
Hypertrophic olivary degeneration following pontine haemorrhage: hypertensive crisis or cavernous haemangioma bleeding?
Krings T, Foltys H, Meister IG, Reul J
J Neurol Neurosurg Psychiatry 2003 Jun;74(6):797-9. doi: 10.1136/jnnp.74.6.797. PMID: 12754356Free PMC Article
Posterior leukoencephalopathy syndrome.
Garg RK
Postgrad Med J 2001 Jan;77(903):24-8. doi: 10.1136/pmj.77.903.24. PMID: 11123390Free PMC Article
MR imaging of the central nervous system in diving-related decompression illness.
Reuter M, Tetzlaff K, Hutzelmann A, Fritsch G, Steffens JC, Bettinghausen E, Heller M
Acta Radiol 1997 Nov;38(6):940-4. doi: 10.1080/02841859709172107. PMID: 9394646

Therapy

An atypical presentation of primary central nervous system lymphoma: A case report.
Yuen CA, Mastrianni J, Ali S, Pytel P, Park DM, Rezania K
Medicine (Baltimore) 2020 Sep 18;99(38):e22062. doi: 10.1097/MD.0000000000022062. PMID: 32957327Free PMC Article
Reversible stenosis of large cerebral arteries in a patient with combined Sjögren's syndrome and neuromyelitis optica spectrum disorder.
Ii Y, Shindo A, Sasaki R, Naito Y, Tanaka K, Kuzuhara S
Rheumatol Int 2008 Oct;28(12):1277-80. Epub 2008 May 21 doi: 10.1007/s00296-008-0611-y. PMID: 18493764
MR imaging of metronidazole-induced encephalopathy: lesion distribution and diffusion-weighted imaging findings.
Kim E, Na DG, Kim EY, Kim JH, Son KR, Chang KH
AJNR Am J Neuroradiol 2007 Oct;28(9):1652-8. Epub 2007 Sep 20 doi: 10.3174/ajnr.A0655. PMID: 17885234Free PMC Article
Productive infection of cerebellar granule cell neurons by JC virus in an HIV+ individual.
Du Pasquier RA, Corey S, Margolin DH, Williams K, Pfister LA, De Girolami U, Mac Key JJ, Wüthrich C, Joseph JT, Koralnik IJ
Neurology 2003 Sep 23;61(6):775-82. doi: 10.1212/01.wnl.0000081306.86961.33. PMID: 14504320
Cerebral microbleeds in CADASIL: a gradient-echo magnetic resonance imaging and autopsy study.
Dichgans M, Holtmannspötter M, Herzog J, Peters N, Bergmann M, Yousry TA
Stroke 2002 Jan;33(1):67-71. doi: 10.1161/hs0102.100885. PMID: 11779891

Prognosis

Intracranial melanotic schwannomas: a rare variant with unusual adherent features.
Mahato D, Vivas-Buitrago T, Gassie K, Jentoft M, Tavanaiepour D, Quiñones-Hinojosa A
J Neurooncol 2018 Jan;136(2):299-306. Epub 2017 Nov 2 doi: 10.1007/s11060-017-2653-z. PMID: 29098570
Hypertrophic olivary degeneration following pontine haemorrhage: hypertensive crisis or cavernous haemangioma bleeding?
Krings T, Foltys H, Meister IG, Reul J
J Neurol Neurosurg Psychiatry 2003 Jun;74(6):797-9. doi: 10.1136/jnnp.74.6.797. PMID: 12754356Free PMC Article
Tectal gliomas in children: the implications for natural history and management strategy.
Dağlioğlu E, Cataltepe O, Akalan N
Pediatr Neurosurg 2003 May;38(5):223-31. doi: 10.1159/000069823. PMID: 12686764
MR imaging of the central nervous system in diving-related decompression illness.
Reuter M, Tetzlaff K, Hutzelmann A, Fritsch G, Steffens JC, Bettinghausen E, Heller M
Acta Radiol 1997 Nov;38(6):940-4. doi: 10.1080/02841859709172107. PMID: 9394646
The management of brainstem gliomas in patients with neurofibromatosis 1.
Pollack IF, Shultz B, Mulvihill JJ
Neurology 1996 Jun;46(6):1652-60. doi: 10.1212/wnl.46.6.1652. PMID: 8649565

Clinical prediction guides

Clinical characteristics of myelin-oligodendrocyte glycoprotein antibody-positive pediatric autoimmune encephalitis without demyelination: A case series.
Song X, Ma J
Front Immunol 2022;13:1050688. Epub 2022 Dec 1 doi: 10.3389/fimmu.2022.1050688. PMID: 36532000Free PMC Article
High titers of myelin oligodendrocyte glycoprotein antibody are only observed close to clinical events in pediatrics.
Lui A, Chong J, Flanagan E, Abrams AW, Krysko KM, Arikan B, Francisco C, Rutatangwa A, Waubant E, Ziaei A
Mult Scler Relat Disord 2021 Nov;56:103253. Epub 2021 Sep 4 doi: 10.1016/j.msard.2021.103253. PMID: 34517190Free PMC Article
Eight-and-a-half syndrome caused by a pontine haemorrhage: a case report and review of the literature.
Xia NG, Chen YY, Li J, Chen X, Ye ZS, Chen SY, Zhu ZG
Int J Neurosci 2018 Aug;128(8):746-750. Epub 2017 Dec 29 doi: 10.1080/00207454.2017.1418344. PMID: 29243534
Striatal Infarction Elicits Secondary Extrafocal MRI Changes in Ipsilateral Substantia Nigra.
Winter B, Brunecker P, Fiebach JB, Jungehulsing GJ, Kronenberg G, Endres M
PLoS One 2015;10(9):e0136483. Epub 2015 Sep 1 doi: 10.1371/journal.pone.0136483. PMID: 26325192Free PMC Article
Exome sequencing reveals mutated SLC19A3 in patients with an early-infantile, lethal encephalopathy.
Kevelam SH, Bugiani M, Salomons GS, Feigenbaum A, Blaser S, Prasad C, Häberle J, Baric I, Bakker IM, Postma NL, Kanhai WA, Wolf NI, Abbink TE, Waisfisz Q, Heutink P, van der Knaap MS
Brain 2013 May;136(Pt 5):1534-43. Epub 2013 Mar 12 doi: 10.1093/brain/awt054. PMID: 23482991

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