PMC10133556_01
Pretreatment MRI cervicodorsal spine and brain image of the patient. (A,B) Sagittal T2/STIR images of the cervicodorsal MRI showed longitudinal extensive T2 hyperintensity in C5-D11 spinal cord segment (yellow bracket) along with brainstem involvement (yellow arrow). (C,D) Axial T2/STIR and T1 Contrast image of dorsal spine showing T2hyperintensity and partial enhancement, respectively, (Yellow arrow). (E,F) Axial FLAIR images how multiple hypointense lesions with surrounding hyperintensity in the left thalamus and the right mesial temporal and middle cerebellar peduncle suggestive of cryptococcal encephalitis (Yellow arrow).
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C7 to D11 vertebral level with partial enhancement, suggestive of a longitudinal extensive transverse myelitis (LETM). The CEMRI brain showed multiple T2W/FLAIR hyperintense lesions in the left frontal, right parietal and left temporal, periventricular white matter, pons, medulla and bilateral cerebellar lobes without any diffusion restriction or post contrast enhancement (Figure 1). Contrast enhanced MRI orbit did not reveal any significant abnormality.
Post-treatment images (6 months after treatment). (A,B) Sagittal T2/STIR image of the cervicodoral MRI. (C,D) Axial T2FLAIR image of brain showing resolution of lesions (blue arrow).
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The follow up imaging done after 6 months showed near complete resolution of lesions (Figures 2, 3).
Timeline of symptoms, management and progression during episode of care.
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The follow up imaging done after 6 months showed near complete resolution of lesions (Figures 2, 3).