PMC8801522_01
The MRI examination documented the presence, at the level of the brain, of hyperintense alteration, in FLAIR images, involving the anterior portion of the corpus callosum and the peri-ependymal white matter at the level of the lateral ventricles. The remaining brain areas of greater expression of aquaporin 4 (diencephalon, midbrain, a pons) did not appear to be affected.
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F1
The brain MRI documented hyperintense alteration in fluid-attenuated inversion recovery (FLAIR) images, involving the anterior portion of the corpus callosum and the periependimal white matter at the level of the lateral ventricles (Figure 1) with mild contrast enhancement on the same areas and on meningeal tissue widely.
The most significant findings were found at the level of the cervico-dorsal cord with evidence, in the T2-weighted sequences, of extended signal hyperintensity which mainly concerned the central component and in particular the gray matter.
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F2
T2-weighted sequences, of extended signal hyperintensity from bulbo-cervical junction to D7 metamer, which mainly concerned the central component and in particular the gray matter (Figure 2), as best evident in the axial acquisition (Figure 3), associated with cord swelling and contrast enhancement on the same level. To exclude a neurologic disorder related to a neoplastic condition such as CNS lymphoma, meningeal carcinomatosis, or paraneoplastic condition, a lumbar puncture was performed; cerebrospinal fluid analysis revealed <10 cells/mcL, increased protein level (366 mg/dl; normal range 15-45), normal glucose level (71 mg/dl; normal range 50-80) and no neoplastic cells.
The most significant findings were found at the level of the cervico-dorsal cord with evidence, in the T2-weighted sequences, of extended signal hyperintensity which mainly concerned the central component as best evident in the axial acquisition.
fmed-08-743798-g0003.jpg
PMC8801522_01_fmed-08-743798-g0003.jpg
F3
T2-weighted sequences, of extended signal hyperintensity from bulbo-cervical junction to D7 metamer, which mainly concerned the central component and in particular the gray matter (Figure 2), as best evident in the axial acquisition (Figure 3), associated with cord swelling and contrast enhancement on the same level. To exclude a neurologic disorder related to a neoplastic condition such as CNS lymphoma, meningeal carcinomatosis, or paraneoplastic condition, a lumbar puncture was performed; cerebrospinal fluid analysis revealed <10 cells/mcL, increased protein level (366 mg/dl; normal range 15-45), normal glucose level (71 mg/dl; normal range 50-80) and no neoplastic cells.