PMC10275341_01
(Case 1) Initial MRI showing ill-defined T1 hyperintensities in the right basal ganglia (A) without changes in the internal capsule and minimal contrast enhancement with gadolinium without surrounding edema (B). Diffusion weighted sequences showing decreased signal in the right basal ganglia with no restriction (C & D). Fluid attenuated inversion recovery (FLAIR) images show isointense signal (E) with hypointenisty on T2 images (F) in the basal ganglia. There was no significant gradient echo (GRE) susceptibility to suggest hemorrhage (G).
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F1
Review of her initial MRI showed an ill-defined lesion in the right caudate and putamen without changes in the internal capsule (Figure 1).
PMC10275341_02
(Case 2) Initial MRI brain images showing T1 hyperintensity in the right basal ganglia (A) with minimal contrast enhancement (B). In the upper lateral aspects of the right caudate, there was a rim of T2 hypointenisty surrounding a central core of T2 hyperintensity (C). The rim had mixed GRE susceptibility (D). There was no evidence of any edema surrounding the right basal ganglia lesion.
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F2
A review of outside records revealed blood glucoses levels ranging from 61-311 mg/dL, and an MRI brain (Figure 2) showed a lesion in the right globus pallidus and possibly involving the putamen. T2 hypointenisty with mixed GRE susceptibility, surrounding a central core of T2 hyperintensity (Figure 2). There was no edema surrounding the right basal ganglia lesion.
PMC10275341_03
(Case 3) MRI brain showing T2 hyperintensity (A) and FLAIR changes (B) seen around the right electrode compared to his prior imaging with associated restricted diffusion (images not available). The signal abnormalities predominantly involved the right thalamus and basal ganglia.
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F3
A repeat MRI brain showed stable lead positions, but revealed T2 hyperintensity and FLAIR changes associated with restricted diffusion around the right electrode in the right thalamus and basal ganglia (Figure 3).