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Patient no. 1. MRI no. I. DWI hyperintensity of the cortex of the posterior part of the left cerebral hemisphere.
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Brain MRI performed on the 9th day of hospital stay showed restricted diffusion (increased signal on DWI; Diffusion-Weighted Imaging) in the left occipital and parietal cortex (Figure 1).
Patient no. 1. MRI no. II, 5 weeks after no. I. FLAIR sequence. Hyperintense signal intensity in the caudate nucleus and striatum bilaterally.
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T2-weighted images in the FSE (fast spin echo) sequence and FLAIR (Figure 2).
Patient no. 1. Immunohistochemical examination. Spongiform changes and perivacuolar pattern of PrP-immunoreactive depositions. Basal ganglia - putamen. PrP x400.
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Positive immunohistochemical test with PrP antybody (3F4, DAKO) confirmed definite diagnosis of Creutzfeldt-Jakob disease (Figure 3).
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Patient no 2. MRI no. I. DWI. Hyperintense signal intensity of the cerebral cortex bilaterally. Sparing of the precentral gyri.
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Brain MRI was performed (outside our hospital) which showed hyperintense signal from the cortex of both hemispheres on FLAIR and DWI sequences (Figure 4).
Patient no 2. MRI no. II, 5 weeks after no. I. DWI. Discretely increased signal intensity in the thalami appeared.
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Subsequent MRI study revealing - apart from cortical lesions - discrete changes in the right caudate nucleus and both thalami (Figure 5) sustained this suspicion.