Figure 1

Central auditory pathway schematic and magnetic resonance imaging features of the patient’s brain. (a) Schematic of the central auditory pathway. The last subcortical station is the medial geniculate body (MGB), where there is ipsilateral projection of fibers to the primary and association auditory cortices. Extensive bilateral decussations exist from the cochlear nucleus (CN), superior olivary nucleus (SON) and inferior colliculus (IC). The majority of fibers reaching the MGB are derived from the contralateral cochlear nerve (black line with grey arrows; lateral lemniscus (LL)). An infarct of the auditory radiation and sensorineural hearing loss of the contralateral ear could cause contralateral monoaural musical hallucinosis. (b,c) T2-weighted magnetic resonance imaging (MRI) sequences showing sublenticular location of infarct (axial, white arrowhead in b; coronal, white arrow in c). (d) Restricted diffusion of the same lesion on diffusion-weighted MRI confirming infarction (black arrowhead).