PMC6323585_01
A) Normal axial un-enhanced computed tomography brain scan, showing as occasional finding a capillary telangiectasia in right putamen. B) Sagittal TSE-T2w magnetic resonance imaging (MRI) shows reduced mamillopontine distance and cerebellar tonsils ectopia, with normal callosal and pontomesencephalic angles; C) venous distention sign is positive (white arrow). D) Axial, E) coronal, and F) sagittal SE-T1w MRI after intravenous gadolinium administration shows diffuse pachymeningeal enhancement; right putaminal capillary telangiectasia is clearly visible
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As an occasional finding, a single CNS capillary telangiectasia was observed in the right putamen (Figure 1).
After 2 months, follow-up SE-T1w magnetic resonance imaging on the three orthogonal plans after intravenous gadolinium administration shows almost complete resolution of the pathological diffuse pachymeningeal enhancement
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After two months, follow-up brain MRI showed almost complete resolution of the imaging pathological findings (Figure 2).
PMC6323585_02
A) Cervical spine and B-D) brain SE-T1w magnetic resonance imaging after intravenous gadolinium administration shows diffuse and intense pachymeningeal enhancement, involving also spinal dura. E) Axial FE T2* shows moderate venous distension and epidural vein engorgement
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MRI examination showed diffuse and intense pachymeningeal enhancement, involving also spinal dura; neither cerebellar tonsils ectopia nor herniation was noticed (Figure 3).
A-C) After 3 months, follow-up SE-T1w magnetic resonance imaging on the three orthogonal plans after intravenous gadolinium administration shows a partial reduction of the diffuse pachymeningeal enhancement
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After three months, follow-up brain and spine MRI showed a persistent dural contrast-enhancement (Figure 4), but it was less pronounced compared to the previous MRI examination.