case_images: PMC4860679_01
case_images: MRI sequences from admission to the OSH 2 days prior to admission at our hospital. These images demonstrate the cerebellar subacute infarction with no restricted diffusion, but contrast enhancement. These images remained unchanged 2 days later on admission to our hospital. (A) DWI, (B) T2, (C) T1 precontrast, and (D) T1 postcontrast.
case_images: fneur-07-00068-g001.jpg
case_images: PMC4860679_01_fneur-07-00068-g001.jpg
case_images: F1
case_images: On the second admission, she had a brain MRI with and without contrast that demonstrated several new abnormalities (Figures 1 and 2), another unremarkable prolonged EEG, and a lumbar puncture. The appearance was consistent with a subacute ischemic infarction that was unchanged from the images obtained the week before (Figure 1).
case_images: MRI brain FLAIR sequences performed on admission to our hospital (A), 7 days after admission (B), 1 month after discharge (C), and 4 months after discharge (D). These images demonstrate the evolution of the left mesial temporal lobe lesion during admission and improvement 1 month and 4 months after discharge.
case_images: fneur-07-00068-g002.jpg
case_images: PMC4860679_01_fneur-07-00068-g002.jpg
case_images: F2
case_images: On the second admission, she had a brain MRI with and without contrast that demonstrated several new abnormalities (Figures 1 and 2), another unremarkable prolonged EEG, and a lumbar puncture. There was also T2 hyperintensity on fluid attenuation inversion recovery (FLAIR) sequences in the left hippocampus, which was unchanged when compared to the images obtained 1 week before (Figure 2). Repeat imaging 1 month and 4 months post-hospitalization showed near complete resolution of the mesial temporal lobe lesion (Figure 2).
case_images: FDG PET CT scan demonstrating increased FDG uptake in the medial left temporal lobe corresponding to the area of increased FLAIR signal seen on MRI brain.
case_images: fneur-07-00068-g003.jpg
case_images: PMC4860679_01_fneur-07-00068-g003.jpg
case_images: F3
case_images: A whole body PET scan also demonstrated no evidence of systemic malignancy, but a hypermetabolic area in the left mesial temporal lobe in the region of the hyperintensity seen on T2 FLAIR was present (Figure 3).