PMC6310360_01
Axial FLAIR brain MRI obtained on admission to the ICU demonstrated (A1) old hyperintense subcortical lesions (arrowhead), new superimposed on old T2/FLAIR hyperintense juxtacortical lesions (A.a arrow), and new lesions (A.b arrow), none of which demonstrated gadolinium enhancement or diffusion restriction.. Parts B-E are follow-up images, please refer to the text for clinical context. Follow-up brain MRI obtained after the patient deteriorated demonstrated a T2 hyperintensity in the ventral-rostral medulla, on axial (arrow, B), and coronal cuts (arrow, C), that was hypointense on T1 sagittal imaging, with a very faint rim enhancement on post-gadolinium sequences (arrowhead E; enhancement, and not well visualized on this image). There were also T2 hyperintense lesions on axial sequences in the caudal medulla (arrows, D), one of which enhanced with gadolinium on the T1 sagittal view (arrow, E).
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F1
Brain MRI demonstrated T2/fluid-attenuated inversion recovery (FLAIR) hyperintense juxtacortical lesions in the bilateral parietal white matter (figure 1).