PMC4821142_01
MRI at the onset of neurological symptoms. Axial T2-weighted fluid-attenuated inversion recovery (FLAIR) shows patchy high-signal intensity PML lesions in the right cerebellar peduncle.
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F1
T2-weighted images in the right cerebellar peduncle without diffusion restriction (fig. 1). MRI angiography and a conventional cerebral angiogram showed no abnormalities of the vascular system and no signs of vasculitis. The total lymphocyte count was 800 x 106/l; there was no anemia or evidence of renal or hepatic dysfunction, and ANA and anti-dsDNA were positive, with a low concentration of complement components C3 and C4.
PMC4821142_02
PMC4821142_03
MRI 5 months later. T2-weighted FLAIR shows a progress of high-signal intensity in the pons.
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F2
At 5 months after hospital admission, the MRI showed further disease progression in the pons (fig. 2).
MRI at the terminal stage of the disease. Axial T2-weighted MRI shows periventricular high-signal intensity.
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F3
At 12 months after the initial diagnosis, a new MRI showed bilateral periventricular high-signal intensity lesions (fig. 3), and the patient died in a persistent vegetative state 1 year after the start of her disease.