PMC4078418_01
52-year-old man with sudden-onset chorea, altered mental status, behavioral alterations, and slurred speech for 2 days, diagnosed with reversible symmetrical basal ganglial lesions bilaterally, related to diabetic nephropathy and chronic renal failure. (a) Axial unenhanced diffusion-weighted image demonstrates symmetrical hyperintense/bright areas involving the basal ganglia bilaterally. (b) Axial unenhanced apparent diffusion coefficient (ADC) image demonstrates reduced ADC values in the central parts and elevated ADC values in the periphery. (c) Axial unenhanced T1-weighted image demonstrates symmetrical hypointense areas involving the basal ganglia bilaterally. No significant mass effect is noted. (d-f) Axial unenhanced T2-weighted, fluid attenuation inversion recovery (FLAIR), and T2*-weighted images show symmetrical hyperintense areas involving the basal ganglia bilaterally.
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F1
Reduced apparent diffusion coefficient (ADC) values were demonstrated in the central parts of the bilateral basal ganglia and increased ADC values were demonstrated in the periphery [Figure 1a and b]. T1-weighted images involving the basal ganglia bilaterally [Figure 1c]. T2-weighted, fluid attenuation inversion recovery (FLAIR), and T2*-weighted images showed symmetrical hyperintense areas involving the basal ganglia bilaterally [Figure 1d-f].
52-year-old man with sudden-onset chorea, altered mental status, behavioral alterations, and slurred speech since 2 days, diagnosed with reversible symmetrical basal ganglial lesions bilaterally, related to diabetic nephropathy and chronic renal failure. Follow-up (a) axial unenhanced diffusion-weighted images, (b) axial unenhanced apparent diffusion coefficient (ADC) images, and (c) axial unenhanced T2-weighted images demonstrate complete resolution of the altered signal intensities in the basal ganglia bilaterally, without any residual abnormalities.
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F2
Follow-up MRI of brain was performed 4 weeks after the first one, which showed complete resolution of the basal ganglial lesions bilaterally [Figure 2].