Primer of Brainstem Anatomy: A Detailed Examination of Anatomy and Pathology Through MRI and DTI

We present a pictorial review of brain stem anatomy and vasculature at the level of the midbrain, pons, and medulla by comparing multiple modalities, including MR imaging, diffusion tensor imaging (DTI), color-coded presentation mapping, and diffusion tensor tractography. This side-by-side comparison explored important nuclei and pathways, such as the pyramidal tracts, transverse pontine fibers, medial longitudinal fasciculus, medial lemniscus, lateral lemniscus, and central tegmental tract. In addition, we introduced clinical case examples, such as congenital anomalies, stroke, neoplasm, neurodegenerative disease, metabolic disease, and Wallerian degeneration. These clinical case examples helped solidify our understanding of brain stem anatomy.

Learning Objectives: List brainstem tracts that can be elucidated with diffusion tractography, and document their normal pathways.