Nothnagel syndrome MRI

A rare midbrain stroke syndrome that involves the tectum of the midbrain, including the quadrigeminal plate.
Classically, the syndrome involves the oculomotor nerve fascicles and superior cerebellar peduncle, leading to ipsilateral CN III palsy and limb ataxia respectively.
Although it can be caused by stroke, especially hemorrhages rather than infarctions, it is more commonly seen due to neoplasm.