case_images: PMC11794125_01
case_images: A 41-year-old woman who had no previous illness was admitted to our hospital complaining of fever and headache for 19 days and consciousness disturbance for 7 days. Brain MRI showed bilateral periventricular T1 hyposignaling (A) Brain MRI revealed T2 hyperintense lesions in the periventricular white matter (B) A corresponding FLAIR sequence showed hyperintense signals (arrows) in the periventricular white matter (C) Brain Contrast-enhanced T1-weighted (arrows) showed linear, radial perivascular pattern of enhancement (D). Spinal MRI sagittal T2 showed diffuse multiple patchy and punctate hyperintensities in the cervical spinal cord and thoracic cord (E, F) Enhanced MRI of the cervical spinal cord showing point-flake diffuse enhancement in the cervical spinal cord (G, H).
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case_images: Brain MRI showed abnormal high signals in the bilateral thalami, basal ganglia, cerebral peduncles, lateral ventricles, centrum semiovale, and subcortical areas, with perivascular radial enhancement around lateral ventricles ( Figures 1A-D ); Spinal MRI showed multiple abnormal high signals in the cervical and thoracic spinal cords ( Figures 1E-H ).
case_images: PMC11794125_02
case_images: A 74-year-old man who was admitted to our hospital complaining of malaise and fatigue for more than 3 months, shaking of both upper limbs for 1 month and shaking of both lower limbs for 1 week. Brain MRI showed bilateral periventricular T1 hyposignaling (A) No abnormal signal is found on the T2 sequence (B) Brain MRI showed bilateral axial FLAIR hyperintensities (arrows) in the periventricular white matter (C) Brain Contrast-enhanced T1-weighted (arrows) showed multiple enhancements in the periventricular (D). Spinal cord MRI T1 and T2 sequences did not show significant abnormal signals (E, F) Enhanced MRI of the cervical spinal cord (arrows) showed cervical medullary surface linear enhancement (G, H).
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case_images: After admission, contrast-enhanced brain MRI showed multiple abnormal enhanced lesions in the brainstem, bilateral temporal lobes, occipital lobes, local pia mater of the cerebellar hemisphere, right frontal lobe, left hippocampal sulcus and gyrus, and bilateral basal ganglia ( Figures 2A-D ). Contrast-enhanced MRI of the entire spinal cord showed silk-like enhancement in the cervical, thoracic, and lumbar spinal cords, as well as the filum terminale ( Figures 2E-H ).
case_images: PMC11794125_03
case_images: A 54-year-old man who had no previous illness was admitted to our hospital complaining of fever for 2 months, headache for 19 days and limb shaking, personality change and memory loss for more than 1 month. No abnormal signal is found on the T1 (A) and DWI (C) sequence; Brain MRI showed T2-weighted (arrows) hyperintensities in the periventricular white matter (B) Brain Contrast-enhanced T1-weighted (arrows) showed linear, radial perivascular pattern of enhancement (D).
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case_images: f3
case_images: Upon admission, brain MRI showed scattered small patchy T2/FLAIR hyperintensities near bilateral cerebral ventricles, with abnormal vascular-like enhancement in bilateral periventricular and 4th ventricular areas ( Figures 3A-D ).