Neuroradiologic findings in an adult patient without a confirmed ACTA2 mutation (patient 15). Neuroradiologic findings in an adult patient without a confirmed.

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Presentation transcript:

Neuroradiologic findings in an adult patient without a confirmed ACTA2 mutation (patient 15). Neuroradiologic findings in an adult patient without a confirmed ACTA2 mutation (patient 15). Sagittal T2WI (A) and axial T2WI at the level of the pons (B) and the midbrain (C) show marked callosal anterior bending (dotted arrow in A), the twin peaks pontine sign (arrow in B), and reduction of the laterolateral diameter of the midbrain with a squeezed cerebral peduncle. D, Sagittal T2WI demonstrates a marked basilar impression on the pons and anterior bending of the midbrain. The parasagittal right slice (E) demonstrates indentation of the lateral surface of the pons (dotted black arrow) and a straight course of the posterior cerebral arteries (white arrow). Axial T2WI (F) at the level of the proximal segment of the posterior cerebral arteries (pontomesencephalic junction) shows marked compression of the brain stem at that level related to straightening of the arteries (white arrows) and radial gyration of the posterior temporal lobes (black dotted arrows). F. D'Arco et al. AJNR Am J Neuroradiol 2018;39:2126-2131 ©2018 by American Society of Neuroradiology