PMC9538924_01
Characteristics and evolution of lesions on brain magnetic resonance imaging (MRI) and computed tomography (CT). (A) Brain MRI on day 1 shows a large hypointensity (arrows) in the left basal ganglia and the temporal lobe on axial T1-weighted imaging (WI); a hyperintense region (arrows) in the left midbrain (B), basal ganglia (C), and temporal-parietal lobe (D) on T2-WI and fluid-attenuated inversion recovery [FLAIR (E)] with space-occupying effect; and individual, small, arc-shaped, ring-shaped lesions are enhanced [(F), arrows]. The MRI on day 5 shows extensive hyperintense lesions enlarged (arrows) in the left midbrain, hippocampus [(G), arrows], basal ganglia, and temporal lobe [(H), arrows] on FLAIR, diffusion-weighted imaging [DWI (I), arrow], and apparent diffusion coefficient [ADC (J), arrow]. CT on day 6 reveals extensive, finger-shaped, low-density areas with space-occupying effects in the left basal ganglia and semioval center [(K), arrow]. MRI on day 34 shows slight hypointensity on T1-WI [(L), arrow], slight hyperintensity on T2-WI [(M,N), arrows], and DWI [(O), arrow], and the space-occupying effect obviously improved. Magnetic resonance imaging on the 25th day after discharge shows hypointensity on T1-WI [(P), arrow], hyperintensity on T2-WI [(Q), arrow], FLAIR [(R), arrow] ADC [(S), arrow], and without diffusion restriction on DWI (T).
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F1
Brain MRI on day 1 (Figures 1A-F) showed extensive foci involving the left frontoparietal-temporal lobe, basal ganglia, and midbrain. However, the anti-infective treatment provided no obvious effect; a repeat MRI on day 5 (Figures 1G-J) and repeat CT (Figure 1K) showed that the lesions had enlarged. The MRI on day 34 (Figures 1L-O) showed that the foci obviously improved. The MRI (Figures 1P-T) on the 25th day after the discharge shows the lesion remained stable.