case_images: PMC9099242_01
case_images: Brain magnetic resonance on (A-D)
  day 1 (E-H)
  day 3, and (I-L)
  day 63 after symptom onset. (A) Diffusion-weighted imaging (DWI) shows bilateral symmetric punctiform restrictive lesions in bilateral thalami. (B) DWI shows single punctiform restrictive pontine lesion. (C) FLAIR imaging shows bilateral hyperintense lesions of the thalami, with no significant mass effect. (D) Susceptibility-weighted imaging (SWI) shows two punctiform hypointense lesions in bilateral thalami. On day 3, (E) DWI shows increase of the restrictive lesions of bilateral thalami, and new peri-insular restrictive lesions (arrow). (F) FLAIR imaging shows relative stability of bilateral hyperintensities involving thalami. (G,H) SWI shows increase hypointense microhemorrhagic lesions of bilateral thalami. On day 63, (I) DWI sequence shows resolution of restrictive lesions. (J) FLAIR imaging sequence reveals near resolution of thalamic hyperintensities. (K) SWI indicates persistence of hypointense microhemorrhagic bilthalamic lesions. (L) T1-weighted imaging shows subtle hypointense lesions in bilateral thalami (arrows).
case_images: fneur-13-872734-g0001.jpg
case_images: PMC9099242_01_fneur-13-872734-g0001.jpg
case_images: F1
case_images: Magnetic resonance imaging (MRI) of the brain performed on day 1 (Figures 1A-D) showed hyperintensities involving bilateral thalami, with some diffusion restriction and microhemorrhagic components. Repeat brain MRI on day 3 showed relative stability of the FLAIR lesions, with increase in the hemorrhagic component within the thalami (Figures 1E-H). Favorable radiological evolution was noted (Figures 1I-L).
case_images: (A) Serum and (B) cerebrospinal fluid (CSF) cytokine profile in the patient and eight healthy age-matched controls from a local biobank. *p <= 0.05; **p <= 0.01; *** p <= 0.001; ****p <= 0.0001.
case_images: fneur-13-872734-g0002.jpg
case_images: PMC9099242_01_fneur-13-872734-g0002.jpg
case_images: F2
case_images: TGF-B (p < 0.0001), and EGF (p = 0.0117) (Figure 2A). There was upregulation in CSF levels of CXCL5 (p < 0.0001), IL-2 (p = 0.0026), IL-3 (p = 0.0004), and IL-8 (p = 0.0145) (Figure 2B).