case_images: PMC10775742_01
case_images: Magnetic resonance imaging performed 7 days after disease onset revealed a bright lesion in the interpeduncular fossa (arrow) on T2-weighted-fluid-attenuated inversion recovery (T2-FLAIR) (c) and diffusion-weighted imaging (DWI) (d). T1-weighted (a) and T2-weighted (b) images at the same level do not clearly show the lesion. Images of layers above the lesion, taken for comparison with follow-up examinations, reveal normal brain tissue (e, T1-weighted; f, T2-weighted; g, T2-FLAIR; h, DWI).
case_images: 10.1177_03000605231208570-fig1.jpg
case_images: PMC10775742_01_10.1177_03000605231208570-fig1.jpg
case_images: fig1-03000605231208570
case_images: MRI performed 7 days after disease onset revealed a bright lesion in the interpeduncular fossa on T2-weighted-fluid-attenuated inversion recovery (T2-FLAIR) and diffusion-weighted imaging (DWI) (Figure 1). Magnetic resonance angiography showed no clinically significant abnormalities in the intracranial blood vessels.
case_images: Magnetic resonance imaging performed at the 16-month follow-up revealed lesion enhancement in the interpeduncular fossa on T2-weighted-fluid-attenuated inversion recovery (T2-FLAIR) (c), as well as new lesions (without significant enhancement; d, h) around the anterior and posterior horns of the lateral ventricles (arrows, e-g). T1-weighted (a) and T2-weighted (b) images at the same level do not clearly show the lesion.
case_images: 10.1177_03000605231208570-fig2.jpg
case_images: PMC10775742_01_10.1177_03000605231208570-fig2.jpg
case_images: fig2-03000605231208570
case_images: T2-FLAIR, as well as new lesions (without significant enhancement) around the anterior and posterior horns of the lateral ventricles (Figure 2). The patient was re-admitted and underwent repeat lumbar puncture to allow screening for infection-related and immunological etiologies.
case_images: Magnetic resonance imaging performed at the 3-year follow-up revealed new lesions (without significant enhancement; d) in the white matter of the left temporal lobe (arrows, a-c). Previously identified lesions around the anterior and posterior horns of the lateral ventricles (e-g) were inconspicuous compared with previous findings (see Figure 2e-g). Lesions without significant enhancement (h) were unchanged relative to previous findings (see Figure 2h).
case_images: 10.1177_03000605231208570-fig3.jpg
case_images: PMC10775742_01_10.1177_03000605231208570-fig3.jpg
case_images: fig3-03000605231208570
case_images: However, MRI revealed new lesions (without significant enhancement) in the white matter of the left temporal lobe (Figure 3), further supporting the diagnosis of MS.