MRI Lesions Mimicking Dawson’s Fingers in a Case of Small Vessel ischemia

FLAIR Sagittal MRI showing Dwason’s finger-like lesions
Sagittal FLAIR MRI showing Dawson’s fingers like lesions perpendicular to the lateral ventricles
Coronal FLAIR MRI images showing periventricular while matter lesions

Dawson’s fingers are periventricular lesions in patients with multiple sclerosis (MS). These are flame-shaped lesions or finger like projections, perpendicular to ventricles and represent perivenular inflammation surrounding medullary veins. Dawson’s fingers are typically seen in patients with multiple sclerosis.

However, here, I present a case of small vessel ischemia, whose MRI showed lesions mimicking Dawson’s fingers. 70-year old gentleman, a hypertensive, presented with headache of one year duration. He had no other neurological symptoms. There were no focal neurological deficits.

Conclusion: Dawson’s fingers like lesions could be seen in patients with small vessel ischemia.

Published by Dr Sudhir Kumar MD (Medicine) DM (Neurology)

I am a doctor with 25 years experience. I have worked as a neurologist for about 20 years. Educating public and healthcare professionals is very dear to me. This is possible due to my interactions with thousands of patients and their caregivers. I salute the patients who suffer and it is our duty to minimise suffering by preventing diseases and ensuring prompt diagnosis and treatment of those already affected.

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