case_images: PMC11731584_01
case_images: A 23-year-old female presented to the emergency department with complaints of a series of 4 seizures accompanied by severe headaches, visual disturbances, and altered mental status. Emergency Magnetic Resonance Imaging (MRI):Brain: (A) T1W Right Para-Sagittal, (B) T1W Left Para-Sagittal, (C, D, E, F, G, H) T2W Axial, (I, J, K, L) FLAIR Coronal shows T1W: multifocal/multi-centric asymmetrical hypointensities in the deep gray matter, deep white matter, sub-cortical white matter U-fibers and cortical white matter (white asterisks). T2W and FLAIR: multifocal/multi-centric asymmetrical hyperintensities/areas (vasogenic edema) in the bilateral ganglio-capsular regions, bilateral thalami (short thin black arrows), bilateral frontal lobes (large thin black arrows), bilateral temporal lobes (short thin white arrows), bilateral parieto-occipital lobes (large thin white arrows), bilateral corona radiata (short thick black arrows), bilateral centrum semiovale (short thick white arrows), bilateral hemipons and bilateral middle cerebellar peduncles (large thick white arrows), bilateral cerebellar hemispheres (large thick black arrows) with effacement of adjacent cerebral sulci and cerebellar foliae.
case_images: gr1.jpg
case_images: PMC11731584_01_gr1.jpg
case_images: fig0001
case_images: T1: multifocal/multi-centric asymmetrical hypointensities, and T2: hyperintensities/areas in the deep gray matter, deep white matter, sub-cortical white matter U-fibers and cortical white matter of bilateral cerebral hemispheres (bilateral ganglio-capsular region, bilateral thalami, bilateral frontal, parietal, temporal, occipital lobes, bilateral corona radiata, bilateral centrum semiovale) (predominantly in bilateral occipital lobes), bilateral cerebellar hemispheres with perifocal sub-cortical mild edema (likely vasogenic edema) with effacement of adjacent sulci (FLAIR: hyperintense, DWI: few areas of patchy reduced diffusivity, SWI: no susceptibility artifacts). T1: Few asymmetrical hypointensities, and T2: hyperintensities in the dorsal and ventral aspects of bilateral hemipons and bilateral middle cerebellar peduncles (FLAIR: hyperintense, DWI: no reduced diffusivity, SWI: no susceptibility artifacts) (Fig. 1, Fig. 2, Fig. 3, Fig. 4).
case_images: A 23-year-old female presented to the emergency department with complaints of a series of 4 seizures accompanied by severe headaches, visual disturbances, and altered mental status. Emergency Magnetic Resonance Imaging (MRI):Brain: (A, B, C, D, E, F) SWI Axial, (G, H, I, J, K, L) SWI-Phase Axial shows SWI: no susceptibility artifacts and SWI-Phase: no susceptibility artifacts in the bilateral ganglio-capsular regions, bilateral thalami (short thin black arrows), bilateral frontal lobes (large thin black arrows), bilateral temporal lobes (short thin white arrows), bilateral parieto-occipital lobes (large thin white arrows), bilateral corona radiata (short thick black arrows), bilateral centrum semiovale (short thick white arrows), bilateral hemipons and bilateral middle cerebellar peduncles (large thick white arrows), bilateral cerebellar hemispheres (large thick black arrows).
case_images: gr3.jpg
case_images: PMC11731584_01_gr3.jpg
case_images: fig0003
case_images: T1: multifocal/multi-centric asymmetrical hypointensities, and T2: hyperintensities/areas in the deep gray matter, deep white matter, sub-cortical white matter U-fibers and cortical white matter of bilateral cerebral hemispheres (bilateral ganglio-capsular region, bilateral thalami, bilateral frontal, parietal, temporal, occipital lobes, bilateral corona radiata, bilateral centrum semiovale) (predominantly in bilateral occipital lobes), bilateral cerebellar hemispheres with perifocal sub-cortical mild edema (likely vasogenic edema) with effacement of adjacent sulci (FLAIR: hyperintense, DWI: few areas of patchy reduced diffusivity, SWI: no susceptibility artifacts). T1: Few asymmetrical hypointensities, and T2: hyperintensities in the dorsal and ventral aspects of bilateral hemipons and bilateral middle cerebellar peduncles (FLAIR: hyperintense, DWI: no reduced diffusivity, SWI: no susceptibility artifacts) (Fig. 1, Fig. 2, Fig. 3, Fig. 4).
case_images: A 23-year-old female presented to the emergency department with complaints of a series of 4 seizures accompanied by severe headaches, visual disturbances, and altered mental status. Follow-up (3 days) Computed Tomography (CT):Brain: (A, B, C, D, E, F) Axial, (G) Right Para-Sagittal, (H) Left Para-Sagittal, (I, J, K, L) Coronal shows multifocal/multi-centric asymmetrical hypodensities (vasogenic edema) in the bilateral ganglio-capsular regions, bilateral thalami (short thin black arrows), bilateral frontal lobes (large thin black arrows), bilateral temporal lobes (short thin white arrows), bilateral parieto-occipital lobes (large thin white arrows), bilateral corona radiata (short thick black arrows), bilateral centrum semiovale (short thick white arrows), bilateral hemipons and bilateral middle cerebellar peduncles (large thick white arrows), bilateral cerebellar hemispheres (large thick black arrows). Vasogenic edema in the deep gray matter, deep white matter, sub-cortical white matter U-fibers and cortical white matter (white asterisks) [Significant reduction / resolution of Vasogenic edema].
case_images: gr5.jpg
case_images: PMC11731584_01_gr5.jpg
case_images: fig0005