PMC5930970_01
Brain MRI findings in the present case. (A and D) Fluid-attenuated inversion recovery (FLAIR), (B and E) diffusion-weighted imaging (DWI), (C and F) gadolinium-enhanced T1-weighted imaging. (A-C) Initial brain MRI on admission showed FLAIR-high lesion sharply delineated toward the precentral gyrus cortex with hyperintense-DWI signal. There was no gadolinium-enhanced lesion at that time. (D-F) Secondary brain MRI a month after admission showed a widely spread periventricular lesion with spotty gadolinium enhancement. These lesions indicate immune reconstruction inflammatory syndrome (IRIS).
NEURIMMINFL2017014282f1.jpg
PMC5930970_01_NEURIMMINFL2017014282f1.jpg
F1
Initial brain MRI on admission showed fluid-attenuated inversion recovery (FLAIR)-high signal lesions sharply delineated toward the cortex and consecutive deep white matter with hyperintense diffusion-weighted imaging (DWI) signals in the left frontoparietal region (figure 1, A and B). There was no mass effect and no gadolinium enhancement in any lesions (figure 1C). One month after admission with gradually worsening aphasia and right hemiplegia, secondary brain MRI revealed several enlarged lesions (figure 1, D and E) with gadolinium enhancement in T1-weighted hypointensity (figure 1F), showing a punctate pattern.