PMC7376414_01
MRI brain with and without contrast showing diffuse leptomeningeal enhancement and several scattered foci of restricted diffusion, particularly in the left frontal and parietal lobes. There are some suggestions of T2/flair signal abnormality in the left frontal lobe with associated enhancement of the parenchyma, which could suggest early cerebritis (yellow arrow).
CRIID2020-8232178.001.jpg
PMC7376414_01_CRIID2020-8232178.001.jpg
fig1
MRI of the brain revealed T2/flair signal abnormalities in the left frontal lobe with associated parenchymal enhancement (refer to Figure 1).
MRI brain with and without contrast showing (a) new left brain stem lacunar infarct (yellow arrow) and (b) worsening sulcal and cisternal T2 hyperintensity and nodular pial enhancement suggesting progression of meningitis. New rather extensive symmetric vasogenic edema due to progressive cerebritis.
CRIID2020-8232178.002.jpg
PMC7376414_01_CRIID2020-8232178.002.jpg
fig2
Ten days later, the patient returned to the hospital after suffering a large brainstem lacunar stroke (refer to Figure 2).