PMC4217759_01
MRI on initial relapse reveals a new lesion in the subcortical white matter of the right parietal lobe with high signal on the FLAIR sequence (arrows, a) and mild contrast enhancement (arrow, b).
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F1
MRI showed a new area of abnormal signal intensity in the subcortical white matter of the right parietal lobe with mild peripheral enhancement (Fig. 1a, b).
MRI 2 months after demonstrating a resolution of the lesion of the right parietal lobe (a) and absence of gadolinium enhancement (b).
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F2
The patient received IV corticosteroids for 5 days and then monthly for 2 months with subsequent clinical and MRI improvement (Fig. 2a, b).
On month 4, MRI demonstrates a new 2-cm lesion in the left cerebellar hemisphere with high signal on FLAIR (arrow, a) and a speckled pattern of contrast enhancement on the post-gadolinium image (arrow, b).
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F3
In post-contrast images, the cerebellar lesion showed enhancement with a speckled pattern, consisting of multiple coalescing punctate foci (Fig. 3a, b).
On a follow-up MRI scan 12 months after the initial relapse, FLAIR images reveal complete resolution of the signal abnormalities in the left cerebellar hemisphere (a) and in the right parietal lobe (b).
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F4
On month 6, 8, 10 and 12 follow-up, the patient showed clinical and MRI improvement (Fig. 4a, b) but still remained under monthly IV corticosteroid treatment.