PMC5681729_01
First magnetic resonance images of the brain. Transverse T2-weighted (A), FLAIR (B), T1-weighted (C), and T1-weighted after IV gadolinium administration (D) images at level of caudate nuclei. There is bilateral and symmetrical T2 and FLAIR hyperintensity and a mild increase in size of both caudate nuclei (arrows). The lesions appear isointense to the normal grey matter on T1-weighted images with clear contrast enhancement (arrowheads). There is no mass effect or loss of anatomical architecture. Oblique-dorsal FLAIR (E) and T1-weighted after IV gadolinium administration (F) images according to the orientation of the caudate nuclei, showing their full extent. Affected areas show extensive hyperintensity on FLAIR images associated with a mild increase in size suggesting swelling (E-arrows), and diffuse contrast-enhancement suggesting blood-brain-barrier breakdown (F-arrowheads).
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F1
MRI showed bilateral and symmetric T2 and FLAIR hyperintensity and a mild increase in size of the caudate nuclei. The lesions were isointense on T1-weighted images with strong and homogeneous contrast enhancement (Fig. 1). Mass effect or loss of anatomical architecture was not present.
Control magnetic resonance images of the brain acquired 2 months after the first scan. Dorsal T2-weighted (A), FLAIR (B), T1-weighted (C), and T1-weighted after IV gadolinium administration (D) images at the level of the caudate nuclei. The caudate nuclei showed an MRI fluid pattern with T2-hyperintensity, strong homogeneous T1 and FLAIR hypointensity without contrast enhancement. There was no mass effect or loss of anatomical architecture. These findings were suggestive of necrotic-malacic evolution of the originary lesions.
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F2
T2-hyperintensity with strong homogeneous T1 and FLAIR hypointensity and did not enhance after contrast medium administration. There was no mass effect or loss of anatomical architecture (Fig. 2).