PMC5019314_01
(A) Videonystagmogram shows no horizontal nystagmus component. (B) Horizontal saccades show hypermetric saccades to the right (arrows).. Abbreviations: R, right; L, left; SPV, slow-phase velocity; sat, saturated.
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Binocular conjugate counterclockwise torsional jerk nystagmus without vertical or horizontal component was demonstrated by videonystagmography (Video S1) (Figure 1A). Extraocular muscles movements, saccadic velocity, and smooth pursuit eye movements were within normal limit except horizontal saccades that were hypermetric to the right (Figure 1B).
MRI of the brain. Thin slice axial T2-weighted with fat suppression shows dolichoectatic left vertebral artery exerting a pressure effect to the left medulla with a hypersignal T2 change at left medulla (arrow).. Abbreviation: MRI, magnetic resonance imaging.
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Magnetic resonance imaging (MRI) of the brain revealed dolichoectatic left vertebral artery, exerting pressure effect to the left medulla (Figure 2).
MRI of the brain. ADC image shows increased diffusion at the left medulla (arrow).. Abbreviations: ADC, apparent diffusion coefficient; MRI, magnetic resonance imaging.
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Increased diffusion on the apparent diffusion coefficient (ADC) image without restricted diffusion on diffusion-weighted imaging (DWI) at the left medulla was also depicted (Figures 3 and 4).
MRI of the brain. DWI shows no restricted diffusion at the left medulla which correlates to increased diffusion in ADC.. Abbreviations: ADC, apparent diffusion coefficient; DWI, diffusion-weighted imaging; MRI, magnetic resonance imaging.
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Increased diffusion on the apparent diffusion coefficient (ADC) image without restricted diffusion on diffusion-weighted imaging (DWI) at the left medulla was also depicted (Figures 3 and 4).
3D TOF MRA of the posterior circulation reveals dolichoectatic left vertebral artery with redundancy to the right (arrow).. Note: Hypoplasia of the right vertebral artery is noted (arrow head).. Abbreviations: 3D, three dimensional; MRA, magnetic resonance angiogram; TOF, time of flight.
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Hypoplasia of the right vertebral artery was also noted (Figure 5).