BMJ Case Reports 2010; doi:10.1136/bcr.05.2010.3003
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A pontomedullary lesion of aberrant pyramidal tract with ipsilateral central facial paresis

  1. Akira Tamaoka
  1. Department of Neurology, Institute of Clinical Medicine, University of Tsukuba,Tsukuba, Japan
  1. Correspondence to Kiyotaka Nakamagoe, Nakamagoek{at}


The patient, a 76-year-old man, developed central facial paresis on the left side (figure 1). Eleven days after the onset of his symptoms, MRI showed a faint area of signal hyperintensity in the left dorsal pontomedullary junction on T1-weighted imaging along with an area of signal hypointensity in the interior of the brainstem and an area of signal hyperintensity in the margin on T2-weighted imaging (figure 2A–C). After 2 months, facial …

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