case_images: PMC10570541_01
case_images: MR imaging of the brain shows bilateral symmetric high signal intensity in the cerebral peduncles (white arrowheads) on T2-weighted images (A), with corresponding faint diffusion restriction (white arrows) on diffusion-weighted images (DWI) (B) axial postcontrast T1-weighted images (C and D) show leptomeningeal enhancement (white lines) along the ventral surface of the midbrain and in the cerebellar folia. Sagittal T2 and axial postcontrast T1-weighted images (E and F) of the spine reveal abnormal hyperintensity of the cervicothoracic spinal cord (white arrow heads in E), along with smooth enhancement of the cuada equina nerve roots (white arrow heads in F).
case_images: fped-11-1269396-g001.jpg
case_images: PMC10570541_01_fped-11-1269396-g001.jpg
case_images: F1
case_images: T2 hyperintensity and mild heterogeneous enhancement in the cervical and thoracic spinal cords, along with smooth enhancement along the cauda equina nerve roots (Figure 1).
case_images: Follow-up axial T2-weighted MR images of the brain (A-C) show cavitary changes in the cerebral peduncles (white arrowheads) with new areas of hyperintensity in the thalami, globi pallidi and dorsal pons. Sagittal and axial T2-weighted images of the spine (D and E) show evolution of the previous spinal cord signal abnormality with development of focal areas of myelomalacia in the anterior horn cells (white arrowheads).
case_images: fped-11-1269396-g002.jpg
case_images: PMC10570541_01_fped-11-1269396-g002.jpg
case_images: F2
case_images: The cauda equina nerve root enhancement persisted on follow-up MRI (Figure 2).