Abstract
A 48-year-old man developed progressive vertigo, ataxia, and dysarthria. MRI demonstrated gadolinium-enhancing abnormalities in the pons and cerebellar peduncles (figure, A). Further investigations excluded neurosarcoidosis, CNS lymphoma, granulomatosis, and paraneoplastic or chronic infectious processes. In particular, 2 CSF examinations revealed mildly elevated protein levels (0.73 g/L, N < 0.40 g/L) without pleocytosis, tumoral cells, or oligoclonal bands. Figure Initial T1-weighted postgadolinium brain MRI (A) Symmetric enhancement of the pons and both cerebellar peduncles, with pattern highly suggestive of a perivascular distribution. (B) Near complete resolution with corticosteroids. (C) Recurrence of the same lesions without corticosteroids. The patient was treated with IV …
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