PMC9267022_01
Unenhanced axial CT scan shows bilateral symmetric hypodensities along both lentiform nuclei and cerebral cortical white matter.
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F1
An initial unenhanced computed tomography (CT) scan showed bilateral symmetrical hypodensities along both lentiform nuclei and was accompanied by bilateral extensive hypodense subcortical white matter changes (Figure 1).
FSE T2-weighted image, bilateral symmetric extensive signal intensity increase along both cerebral hemispheres subcortical region and also bilateral putamina.
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F2
Bilateral hyperintense symmetric signal intensity changes were also present along both lentiform nuclei (Figure 2).
a DWI reveals increased signal intensity on both putaminal and cerebral subcortical white matter regions. b ADC map shows decreased signal intensity on corresponding brain regions indicating restricted diffusion due to cytotoxic edema.
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F3
Diffusion-weighted imaging (DWI) revealed high signal intensity and ADC showed low signal intensity in the corresponding brain regions consistent with restricted diffusion (Figure 3a and b).
a Magnitude SWI demonstrated hypointense hemorrhagic foci on both putaminal regions. b Phase-contrast SWI reveals opposite signal intensity due to positive shift effect of deoxyhemoglobin on left-handed MRI system.
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F4
SWI detected hemorrhagic foci in both lentiform nuclei with a hypointense signal on magnitude images and hyperintense signal on phase-contrast images due to the positive shift effect of paramagnetic deoxyhemoglobin (Figure 4a and b).