PMC9271741_01
Side to side comparison MRI flair day 1 (A), day 6 (B), day 14 (C) and day 45 (D). The follow-up MRIs shows a gradual reduction of the initially displayed leptomeningeal enhancement in the left temporal, parietal and occipital lobes. The substance defect after astrocytoma excision appears as a liquid-filled black cyst in the lower part of the right hemisphere (left-sided in the pictures).
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F1
MRI showed signs of a pronounced left-sided temporo-parieto-occipital meningoencephalitis with cortical blood-brain barrier damage, leptomeningeal enhancement as well as a small left-sided parieto-occipital infarction (Figure 1). Accordingly, a distinct regression of the inflammation was found in MRI (Figure 1).
(A) Visual perception recovery during hospitalization (right hemifield); (B) Visualization of the treatment with corticosteroids: Steroid pulse therapy with 1 g intravenous methylprednisolone during the first 3 days (striped pattern) followed by oral therapy with prednisolone 100mg gradually reduced over 9 weeks.
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F2
His symptoms rapidly improved under this treatment (Figure 2).