PMC10391538_01
(A-F) DWI showed asymmetric cortical hyperintensity in the bilateral caudate nucleus, bilateral cingulate gyrus and frontoparietal, temporal and occipital gyrus, especially in the left. (G-L) Small patchy long T2 signal shadow was observed next to the posterior horn of the left lateral ventricle. There was no abnormal signal shadow in the remaining bilateral cerebral hemispheres, cerebellum, and brain stem, no abnormal morphological structure was found, the ventricular system was equal and symmetrical, the sulci cistern fissure was not significantly widened, and the midline structure was centered.
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F1
When the patient's medical history and family genetic history were investigated, the patient's family members denied any relevant medical history or neurological symptoms within the family (Figure 1).
Electroencephalogram (EEG) showed that the basic rhythm disappeared, periodic three-phase waves appeared in all leads, with an inter-wave interval of 0.5-0.7s.
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F2
Further examination of diffusion-weighted imaging (DWI) results revealed multiple abnormal diffusion-restricted signal changes in the brain with cortical and subcortical distribution, indicating a high possibility of infectious lesions and Creutzfeldt-Jakob disease (CJD) (Figure 2).