case_images: PMC9900216_01
case_images: Magnetic Resonance imaging revealed a left occipital lesion (small arrows), which was hyperintense on fluid-attenuated inversion recovery imaging (A) and diffusion-weighted imaging (B) and isointense on apparent diffusion coefficient map (C). Proton magnetic resonance spectroscopy (D) revealed a markedly elevated lactate peak at 1.3 ppm (large arrow) and a decreased N-acetyl aspartate/creatine ratio in the left occipital lesion.
case_images: cmj-59-100-g001.jpg
case_images: PMC9900216_01_cmj-59-100-g001.jpg
case_images: F1
case_images: The patient then underwent brain magnetic resonance imaging (MRI) (Fig. 1A-C). Fluid-attenuated inversion recovery imaging (Fig. 1A) and diffusion-weighted imaging (DWI) (Fig. 1B) revealed a high signal intensity lesion in the left occipital lobe, which was isointense on the apparent diffusion coefficient (ADC) map (Fig. 1C). Additionally, proton MR spectroscopy (MRS) (Fig. 1D) showed an elevated lactate peak and a decreased N-acetyl aspartate/creatine ratio in the lesion, which suggested increased anaerobic glycolysis.