PMC4896169_01
Urine microscopy demonstrates "cigar" and "envelope" crystals, a pattern characteristic of calcium oxalate monohydrate and calcium oxalate dihydrate crystals respectively.
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Microscopic examination of the urine demonstrated cigar and envelope shaped crystals characteristic of calcium oxalate crystals (Figure 1).
Unenhanced head CT shows diffuse hypodensity in the deep gray matter nuclei with loss of differentiation of the deep gray matter nuclei and subjacent white matter compatible with edema.
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Due to clinical concern for seizure activity, head computed tomography (CT) was performed which showed diffuse hypodensity within the bilateral basal ganglia and thalami with loss of differentiation with the subjacent white matter, compatible with edema (Figure 2).
Axial T2WI (A) and FLAIR (B) images demonstrate symmetrical increased signal intensity within the basal ganglia, thalami, amygdala, hippocampus, and brainstem bilaterally.
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T2 and fluid attenuation inversion recovery (FLAIR) sequences within the basal ganglia, thalami, amygdala, hippocampus, and brainstem bilaterally (Figure 3). There was restricted diffusion within the white matter tracks of the corona radiata bilaterally (Figure 4) on diffusion weighted (DWI) and apparent diffusion coefficient (ADC) imaging.
Axial DWI (A) and ADC (B) images at the level of corona radiata demonstrates restricted diffusion bilaterally.
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T2 and fluid attenuation inversion recovery (FLAIR) sequences within the basal ganglia, thalami, amygdala, hippocampus, and brainstem bilaterally (Figure 3). There was restricted diffusion within the white matter tracks of the corona radiata bilaterally (Figure 4) on diffusion weighted (DWI) and apparent diffusion coefficient (ADC) imaging.