A 57 year old woman with diabetes developed a right sided hemiparesis. There was no aphasia.

(Left) T2 weighted axial MRI; (Right) Diffusion weighted MRI. Note the high signal in the left pons. On the diffusion weighted image, the lesion is bright, denoting that is acute. This lesion is in the distribution of one perforating branch off the basilar artery. Although occasionally associated with intrinsic basilar disease or an embolus to the basilar artery, this lesion usually represent the occlusion of one perforating basilar branch from the process of lipohyalinosis, which occurs as a result of aging, diabetes and hypertension.

Revised 05/19/06.
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