case_images: PMC8135193_01
case_images: Neuroimaging findings. MRI scan of the brain revealed diffuse signal abnormalities within the subcortical white matter, thalamus, and basal ganglia. T1-weighted, T2 FLAIR, gradient echo sequence, and ADC images at the level of midbrain (A), basal ganglia (B) and centrum semiovale (C). Bilateral asymmetric foci of increased T2-signals are demonstrated (arrows) involving the thickened cortices, thalami, and globus pallidi but sparing the posterior fossa structures (not shown), brainstem or centrum semiovale. Gradient echo sequence images showed no hemorrhagic areas. The areas of T2-prolongation did not show diffusion restriction or contrast enhancement (not shown).
case_images: 10.1177_2329048X211016109-fig1.jpg
case_images: PMC8135193_01_10.1177_2329048X211016109-fig1.jpg
case_images: fig1-2329048X211016109
case_images: Brain MRI revealed diffuse hyperintensities on T2 and FLAIR sequences within the subcortical white matter, thalamus, and basal ganglia (Figure 1 ).
case_images: Histopathologic findings from a biopsy specimen of the right parietal lobe. (A) A section stained with H&E revealed that parenchymal vessels were surrounded by a marked mixed inflammatory infiltrate with fibrinoid necrosis (white arrow) and perivascular hemorrhage (black arrow). (B) A section stained with Luxol fast blue and H&E revealed peri-vascular demyelination (arrow). (C) A section immunohistochemically stained for CD68 antigen revealed a marked macrophage infiltrate (arrow). (D) A section immunohistochemically stained for neurofilament revealed patchy axonal loss (arrow).
case_images: 10.1177_2329048X211016109-fig2.jpg
case_images: PMC8135193_01_10.1177_2329048X211016109-fig2.jpg
case_images: fig2-2329048X211016109