PMC4017713_01
(a) Thoracic and lumbar sagittal MRI and T1 postgadolinium contrast image demonstrating areas of intramedullary enhancement at the levels of T9 and T11, as well as cauda equina enhancement (blue arrow). (b) Sagittal T2 image showing corresponding areas of T2 hyperintensity at the same levels. (c) Sagittal T1 postgadolinium contrast demonstrates enhancement at multiple thoracic levels. (d) Sagittal T2 image after 6 weeks of antiviral treatment demonstrating near resolution of these changes (postcontrast image, not shown, demonstrates resolution of enhancement).
CRINM2014-694750.001.jpg
PMC4017713_01_CRINM2014-694750.001.jpg
fig1
T1 postcontrast images revealed numerous foci of intramedullary enhancement, including some that were ring enhancing. There was also enhancement of the leptomeninges including the cauda equine (Figure 1). Repeat MRI of the thoracic and lumbar spine showed improvement of the intramedullary lesions, both in number and size (Figure 1(c)).
(a) Axial T1 postcontrast image demonstrates an area of ependymal enhancement at the margin of the left lateral ventricle. (b) Sagittal postcontrast T1 volumetric image shows areas of enhancement in the cervical spinal cord (yellow arrows) as well as some areas of pachymeningeal enhancement (blue arrow).
CRINM2014-694750.002.jpg
PMC4017713_01_CRINM2014-694750.002.jpg
fig2
Axial T1 postcontrast brain imaging demonstrated ependymal enhancement at the margin of the left lateral ventricle (temporal horn) as well as enhancement in the cervical spinal cord (yellow arrows) and pachymeningeal enhancement (Figure 2).
Axial postcontrast T1 volumetric reformatted images demonstrate enhancement of the facial nerve (a) and bilateral trigeminal nerves (b).
CRINM2014-694750.003.jpg
PMC4017713_01_CRINM2014-694750.003.jpg
fig3
Additionally, there was abnormal enhancement of the left facial and bilateral trigeminal nerves (Figure 3).