PIGLET SIGN OF CENTRAL PONTINE MYELINOLYSIS

A 35 year chronic alcoholic old man, was admitted with altered sensorium since last 3 days. His MRI Brain done on Day 3 of admission revealed Hyperintense signal change in pons with partial sparing of the tegmentum, ventrolateral pons and corticospinal tracts on FLAIR and T2 weighted images suggestive of central pontine myelinolysis. The T2W axial images resembled the face of a pig with the temporal lobes representing ears, the carotid arteries the eyes, the abnormal pontine signal representing snout and the fourth ventricle the mouth. Recognition of this pattern -the piglet sign may aid in the differential diagnosis of pontine lesions.