PMC6057278_01
Initial and follow-up MRI brain for Case    1. (a) Initial MRI: axial T2-weighted image with hyperintensities in the bilateral basal ganglia. (b) Initial MRI: coronal FLAIR-weighted image with hyperintensities in the bilateral basal ganglia. (c) Follow-up MRI: axial FLAIR-weighted image with hyperintensities in the bilateral basal ganglia. (d) Follow-up MRI: axial T1-weighted image with hyperintensities in the bilateral basal ganglia.
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fig1
Initial brain magnetic resonance imaging (MRI) with and without gadolinium showed symmetric T2 hyperintense and T1 hypointense basal ganglia abnormalities [Figures 1(a) and 1(b)]. A repeat brain MRI three weeks later redemonstrated symmetric T2 hyperintense basal ganglia but with a transition to T1 hyperintensities in the same location [Figures 1(c) and 1(d)].
PMC6057278_02
MRI brain imaging for Case    2. (a) MRI brain FLAIR imaging. This image demonstrates mildly expansile T2 signal hyperintensity of the left greater than right mesial temporal lobes. Additional small regions of cortical and subcortical T2 signal hyperintensity are noted in the temporal lobes of both hemispheres. (b) MRI brain, T1 sequence with contrast. There is no enhancement noted in the affected areas after administration of gadolinium contrast.
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fig2
Additionally, there were 2 enhancing foci within the left occipital and right temporal lobes, concerning for metastatic disease [Figure 2]. Her most recent brain MRI demonstrated interval resolution of enhancing foci and abnormal T2 signal in the temporal lobes [Figure 2].