case_images: PMC7779795_01
case_images: PMC7779795_02
case_images: PMC7779795_03
case_images: Brain MR images at age 27 (A) and 19 months later (B), with axial fluid attenuation inversion recovery (FLAIR) images (top and middle rows) and coronal T1-weighted images (bottom row). Note progression of the bilateral medial frontal, anterior temporal, and caudate head atrophy with the associated ventricular enlargement on the axial FLAIR images. The orbitofrontal as well as dorsomedial, anterior temporal, and caudate head atrophy are obvious on the coronal images. Images are in standard radiology orientation.
case_images: fneur-11-600468-g0001.jpg
case_images: PMC7779795_03_fneur-11-600468-g0001.jpg
case_images: F1
case_images: For workup of medically refractory psychosis, she completed a brain MRI which showed bilateral medial frontal, anterior temporal, and caudate head atrophy (Figure 1A). MRI performed 19 months after the initial scan showed a progression of the medial frontal, anterior temporal, and caudate head atrophy with the associated ventricular enlargement (Figure 1B).
case_images: Statistical z-score maps of brain FDG-PET at age 27, with the degree of hypometabolism reflected by the color bar on the left; dark blue is within normal limits and red is maximally abnormal. Note the degree of hypometabolism is severe in the orbitofrontal and caudate regions, moderate in the frontotemporal regions (left slightly more so than right), and mild to moderate in the parietal and posterior cingulate regions.
case_images: fneur-11-600468-g0002.jpg
case_images: PMC7779795_03_fneur-11-600468-g0002.jpg
case_images: F2
case_images: Three weeks later, a fluorodeoxyglucose (FDG)-positron emission tomography (PET) scan was performed, which showed hypometabolism that was severe in the orbitofrontal and caudate regions, moderate in the frontotemporal regions, and mild to moderate in the parietal and posterior cingulate regions (Figure 2).