case_images: PMC6362841_01
case_images: T2-weighted magnetic resonance image of patient's brain demonstrates T2 hyper-intense signal with associated diffusion restriction in the cortex, predominantly in the parietal and temporal lobes, and predominantly on the left. Note associated gyral thickening.
case_images: nihms-998742-f0001.jpg
case_images: PMC6362841_01_nihms-998742-f0001.jpg
case_images: F1
case_images: A repeat brain MRI showed bilateral cortical ribboning not reported on previous imaging (Figure 1).
case_images: MRI of patient's brain over a year prior to presentation at our institute, reported as notable only for evidence of chronic small vessel disease. Diffusion weighted sequence imaging (left) indicates cortical ribboning retrospectively though T2-weighted image (right) does not yet reflect these findings and there is no gyral thickening.
case_images: nihms-998742-f0002.jpg
case_images: PMC6362841_01_nihms-998742-f0002.jpg
case_images: F2
case_images: While the documented imaging reports did not report CJD-associated MRI findings, subsequent review of the images indicated that our patient had evidence of cortical ribboning on early imaging done at initial evaluation (Figure 2).