case_images: PMC10578331_01
case_images: Brain MRI. Images from a February 2022 MRI scan are shown; the obtained images were mildly degraded by motion artifact. A-C) Coronal T2 high-resolution 3MM sequence depicting left greater than right hippocampal volume loss in the anterior, medial, and posterior hippocampus regions. There is also significant ex vacuo dilatation of the third ventricle. D-G) Axial T2 FLAIR BLADE sequence showing focal signal hyperintensity (arrow) in the pyramidal tract on the left (D), potentially reflective of Wallerian degeneration consequent to a past stroke or selective primary degeneration of upper motor neurons. There are small, chronic, bilateral signal changes thought to represent sequelae of subcortical infarcts in the anterior temporal (E), basal ganglia/thalamus (F), and internal capsule (G) regions.
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case_images: adr-7-adr230103-g001
case_images: Two brain MRIs showed stable signal abnormalities in the right putamen and thalamus, which were felt to represent remote infarcts or possibly sequelae of a Wernicke's encephalopathy event (Fig. 1).
case_images: Cervical MRI. An MRI of the cervical spine and cord was obtained because of concomitant signs of central and peripheral motor system dysfunction at a cervical level. A) Axial GRE T2 sequence showing subtle T2 hyperintensity in the right (arrow) greater than left corticospinal tract. Sagittal T1 (B) and sagittal T2 (C) sequences without evidence of cord compression.
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case_images: Cervical MRI ruled out structural-induced myelopathy (Fig. 2) and revealed neither cervical cord nor nerve root compression.