case_images: PMC11725491_01
case_images: Brain MRI images of Case 1: (A) Axial T2WI, (B and C) Sagittal T2WI, (D and E) Coronal FLAIR, (F) DWI, and (G) Apparent Diffusion Coefficient (ADC). The scans reveal multifocal hyperintense foci in the ventral medulla and pons (white thick arrows), periventricular white matter and corpus callosum (red thick arrows), and subcortical white matter (green thick arrow). The periventricular white matter lesions are arranged perpendicular to the ependymal surface, appearing hyperintense on DWI and iso-hyperintense on ADC mapping (black thick arrows).
case_images: CCR3-13-e70095-g004.jpg
case_images: PMC11725491_01_CCR3-13-e70095-g004.jpg
case_images: ccr370095-fig-0001
case_images: Cervical and proximal thoracic spine MRI images of Case 1, (A) Sagittal T2WI, (B) Sagittal STIR, (C) Contrast-enhanced sagittal T1WI, and (D and E) Axial T2WI. The scans demonstrate multifocal long-segment T2 hyperintensity in the cervical and proximal thoracic spinal cord (white thick arrows), involving the medulla oblongata and cervico-medullary junction, with no contrast enhancement observed. The lesion involves more than two-thirds of the circumference of the upper spinal cord and the dorsal portion of the lower cervical and proximal thoracic spinal cord.
case_images: CCR3-13-e70095-g001.jpg
case_images: PMC11725491_01_CCR3-13-e70095-g001.jpg
case_images: ccr370095-fig-0002
case_images: PMC11725491_02
case_images: Brain MRI images of case 2: (A) Sagittal T2-weighted imaging (T2WI), (B) Axial FLAIR, and (C) Axial T2WI. The scans demonstrate hyperintense foci in the pons (white thick arrows).
case_images: CCR3-13-e70095-g003.jpg
case_images: PMC11725491_02_CCR3-13-e70095-g003.jpg
case_images: ccr370095-fig-0003
case_images: Cervical spine MRI images of case 2: (A and B) Sagittal T2WI, (C) Contrast-enhanced sagittal T1WI, and (D) Axial T2WI. The scans reveal multifocal long-segment T2 hyperintensity in the cervical spinal cord and cervico-medullary junction (white thick arrows), with no contrast enhancement. The lesion encompasses more than two-thirds of the circumference of the upper cervical spinal cord.
case_images: CCR3-13-e70095-g005.jpg
case_images: PMC11725491_02_CCR3-13-e70095-g005.jpg
case_images: ccr370095-fig-0004
case_images: PMC11725491_03
case_images: Brain MRI images of case 3: (A) Axial T2-weighted imaging (T2WI) and (B) Sagittal T2WI. The scans reveal periventricular hyperintense foci arranged perpendicular to the ependymal surface (red thick arrows).
case_images: CCR3-13-e70095-g006.jpg
case_images: PMC11725491_03_CCR3-13-e70095-g006.jpg
case_images: ccr370095-fig-0005
case_images: Despite initial management, her condition did not improve, and after neurologist consultation, the diagnosis of NMOSD was made with the help of brain and spinal MRI as shown in Figures 5 and 6 that leads to the initiation of immunosuppressive therapy with intravenous methylprednisolone followed by oral prednisolone, cotrimoxazole, omeprazole, and physiotherapy.
case_images: Cervical spine MRI images of case 3: (A and B) Axial T2WI, (C) Sagittal T2WI, and (D) contrast-enhanced axial T1-weighted imaging. The scans demonstrate long-segment T2 hyperintensity throughout the entire cervical spinal cord (white thick arrows), with no contrast enhancement observed (green thick arrow). The lesion involves the full circumference of the upper cervical spinal cord and the dorsal portion of the lower cervical spinal cord.
case_images: CCR3-13-e70095-g002.jpg
case_images: PMC11725491_03_CCR3-13-e70095-g002.jpg
case_images: ccr370095-fig-0006
case_images: Despite initial management, her condition did not improve, and after neurologist consultation, the diagnosis of NMOSD was made with the help of brain and spinal MRI as shown in Figures 5 and 6 that leads to the initiation of immunosuppressive therapy with intravenous methylprednisolone followed by oral prednisolone, cotrimoxazole, omeprazole, and physiotherapy.
case_images: PMC11725491_04
case_images: PMC11725491_05