Case 91

 Case 1 A fifty five-year-old male experienced sudden numbness of upper and lower extremities, inarticulate speech, tinnitus and vomiting during hot bath at home approximately two months ago. He went to an emergency hospital and got some treatment. Ten days later, he was introduced to our hospital for receiving rehabilitation. He was still suffering from discoordination to move right upper extremity, numbness of right upper and lower extremities, and inarticulate speech. He received brain MRI to check the expansion and the exact site of brain stroke (Fig. 1).

 Case 2 An eighty two-year-old female experienced sudden right hemineglect, hemiparesis and inarticulate speech (dysarthria). She was transported to the emergency hospital. At first, her motor strengths of right upper and lower extremities were at the level of 0/5 and 0/5, respectively. But rehabilitation made the hemiparesis improving to the level of 3/5 of both upper and lower extremities. Thereafter, she was introduced to our hospital for continuing the rehabilitation with her brain MRI.

Based on clinical findings and brain MRI (Fig. 1, 2), what tracts of pons are involved in these patients?

Case1

1. Medial lemniscus

2. Trigeminal nucleus-nerve tract

3. Lateral spinothalamic tract

4. Middle cerebellar peduncle

5. Cortico-nuclear tract

Case2

1. Corticospinal tract

2. Cortico-pontine nucleus

3. Medial lemniscus

4. Lateral spinothalamic tract

5. Cortico-nuclear tract

answer

2018.2.7