Osmotic myelinolysis is a distinctive clinical syndrome with a characteristic "bat wing" MRI lesion in the central pons, which is also called central pontine myelinolysis (CPM). However, demyelinating lesions are not only limited to the central pons, but also may be involved in the extrapontine regions including the basal ganglia, thalamus, and cerebellum (extrapontine myelinolysis; EPM). We report an atypical case of osmotic myelinolysis confined to the pyramidal tract from the precentral gyrus to the central pons via the corona radiata and internal capsule in a MR image.
Basal Ganglia ; Cerebellum ; Internal Capsule ; Magnetic Resonance Imaging ; Myelinolysis, Central Pontine ; Pons* ; Pyramidal Tracts* ; Thalamus

Intravascular lymphomatosis (IL) is known as a rare and fatal disease characterized by massive intravascular proliferations of B or T lymphoid cells and manifests in the nervous system and skin. However diagnosis is usually made at the time of autopsy because of the lack of characteristic clinical or laboratory findings. Therefore, IL may be confused with various forms of neurological diseases including demyelinating disease, encephalitis, vasculitis or stroke. We report a case of post-mortem confirmed IL presenting as demyelinating disease.
Autopsy ; Demyelinating Diseases* ; Diagnosis ; Encephalitis ; Lymphocytes ; Nervous System ; Skin ; Stroke ; Vasculitis