Fig. 6
A 35-year-old female patient with RRMS, EDSS score of 4, and a relapse rate of 6, complaining of visual problems, cerebellar dysfunction, bowel, and bladder dysfunction. Axial and sagittal Flair sequences (a–c) showed multiple plaques of high SI at both parietal lobes; in periventricular white matter, pericallosal and callosomarginal areas, juxtacortical junction, and centeum semiovale. The periventricular plaques are perpendicular to the ventricle giving Dawson’s finger appearance. 3D T1W images in sagittal view (d, e) for brain stem segmentation and in coronal view (f, g) for cerebellar grey and white matter segmentation; (d, f) raw unprocessed T1W image, (e, g) 3D T1image after processing with 3D Slicer with colored segmented brain stem and cerebellum structures. The brain stem and cerebellum segmentation results showed the following data: midbrain 5.02 (N 5.24–6.33 cm3), pons 11.7 (N 12.66–16.51 cm3), medulla 3.1 (N 4.25–5.12 cm3), whole brain stem 19.82 (N 22.46–28.10 cm3), left cerebellar white matter 19.42 (N 19.06–25.21 cm3), left cerebellar grey matter 76.57 (N 84.39–102.17 cm3), right cerebellar white matter 20.61 (N 18.55–25.54 cm3), and right cerebellar grey matter 76.07 (N 84.36–101.87 cm3). Patient with EDSS score of 4 and a relapse rate of 6 had a minimal decrease in the volume of the midbrain, severe decrease in the volumes of the pons, medulla, whole brain stem, and cerebellar grey matter bilaterally