RESUMEN
BACKGROUND: Wernekink commissural syndrome (WCS) is a distinct midbrain syndrome that involves the caudal tegmentum of the midbrain and selectively damages the Wernekink commissure involved in the decussation of the superior cerebellar peduncle in midbrain. The aim of the study was to explore the clinical manifestations, imaging characteristics, and differential diagnosis of WCS in midbrain infarction to provide reference for clinicians in the diagnosis of WCS. CASE SUMMARY: The clinical data of 4 patients with WCS with midbrain infarction were analyzed retrospectively. WCS is a rare syndrome that can be diagnosed based on its characteristic symptoms and imaging findings of magnetic resonance imaging. CONCLUSION: Clinicians should look for this syndrome in cases of bilateral cerebellar dysfunction and eye movement disorders.