PMC7649756_01
(A) Magnetic resonance brain images with fluid attenuated inversion recovery (FLAIR) sequences of October 2017, when patient presented with recurrent seizures. Images show distinct cerebral small vessel disease. (B) Diffusion weighted imaging sequences of the same examination show point-shaped infarction in left-sided MCA-territory (white arrow). (C) FLAIR sequence of April 2018 when patient deteriorated clinically with clear increase of white matter damage. (D) FLAIR sequence of October 2018, when patient presented for fifth cycle of cyclophosphamide treatment and with a marked clinical improvement. Images show a clear reduction of small vessel disease.
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Cerebral MRI showed severe small vessel disease and a fresh ischemic lesion in the left middle cerebral artery territory (Figures 1A,B). The brain MRI showed progressive small vessel disease (Figure 1C). MRI control image showed a reduction of the leukoencephalopathy (Figure 1D).