PMC9853935_01
Schematic presentation of pain and temperature sensation disorder (A). MRI findings obtained 3 days after symptom onset (B-E). Axial (B) and sagittal (C) diffusion-weighted images showing restricted diffusion in the right caudal lateral medulla (arrows). Axial fluid-attenuated inversion recovery image (D) showing high-intensity areas in the right lateral medulla (arrows). Magnetic resonance angiography findings (E) illustrating the enlargement of the right vertebral artery (arrows). Topography of the lateral spinothalamic tract of the caudal level of the medullary oblongata (F). The grey area representing the presumed ischemic lesion in this case. S, sacral; L, lumbar; T, thoracic; C, cervical.
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She had lost temperature and pain sensation below the left C5 sensory level (Fig. 1A), while her sensations of touch, position and vibration were intact. Magnetic resonance imaging (MRI) findings revealed high-intensity signals in the right caudal lateral medulla oblongata on diffusion-weighted imaging (Fig. 1B and C), fluid-attenuated inversion recovery (Fig. 1D) and an enlarged right vertical artery (Fig. 1E).