PMC10246339_01
(a and b) Preoperative computed tomography brain shows massive cerebral edema with midline shift. b
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F1
CT brain is shown in Figure 1.
(a-c) Magnetic resonance imaging (MRI) fluid-attenuated inversion recovery, T2MRI, diffusion-weighted imaging MRI, brain showing diffuse scattered patchy hyperintensities affecting mainly the right temporal and parietal lobes, and left hippocampus. RPH: Relative peak height, RPF: Relative peak flow.
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F2
Magnetic resonance imaging (MRI) with contrast is requested urgently Figure 2.
(a and b) Diffuse demyelination of the cortical white matter with abundant mononuclear inflammatory cells most of them are lymphocytes with reactive pink gliosis. (c) CD68/SRD1 staining is positive showing monocytes and macrophages distribution in the perivascular areas.
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F4
Histological features are characteristic of ADEM, as shown in Figure 4.