PMC8131984_01
(A) Diffusion-weighted imaging and ADC mapping show acute ischemic lesions in the right caudate nucleus (B) Diffusion-weighted imaging and ADC mapping shows acute ischemic lesions ingenue of the internal capsule on the left side (C) T2- weighted cranial MR imaging shows bilateral centrum semiovale and periventricular subcortical white matter hyperintensities, cryptococcomas (D) T2- weighted cranial MR imaging shows the chronic ischemic gliotic area (E) T2- weighted cranial MR imaging shows cerebral atrophy and hydrocephalus in the following time of the treatment (F) chronic lesions in the post-treatment period.
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Based on the radiological appearance, infectious pathologies, lymphoma, or vasculitis were considered presumptively in the differential diagnosis (Fig. 1A). The acute ischemic cerebrovascular event was determined by cranial MR imaging and acetylsalicylic acid was ordered (Fig. 1B). The lesions in the previously performed cranial imaging were interpreted as cryptococcoma (Fig. 1C). Cranial MRI was performed and the triventricular hydrocephaly was detected (Fig. 1E). His clinical condition was improved completely, and cranial imaging showed regression of previous lesions (Fig. 1F).
India ink stain of CSF demonstrating encapsulated yeast-like fungus, Cryptococcus neoformans.
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On microscopic examination of CSF, cryptococcus-like encapsulated yeasts were demonstrated with India ink (Fig. 2).