PMC6119709_01
Bilateral, hypodense basal ganglia necrosis in unenhanced CT (arrows); Philips Ingenuity 5 mm.
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F1
An unenhanced computed tomography (CT) of the head showed almost symmetrical bilateral hypointensities of the globus pallidus (Figure 1).
Bilateral basal ganglia necrosis with T2w hyperintense alterations (A) and hemoside deposits (B). These changes are diffusion-disturbed (C,D). 3 T Philips Ingenia, (A) FLAIR, (B) SWI, (C) b1000 image, (D) ADC map.
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F2
MRI of the brain 3 weeks after hospitalization confirmed the bilateral lesions of the globus pallidus seen on CT, characterized by restricted diffusion and FLAIR-hyperintense signal changes (Figure 2).
Planar T2w hyperintense signal changes of the entire white matter (A) with diffusion restriction (B,C) 3 T Philips Ingenia, (A) FLAIR, (B) b1000 Figure, (C) ADC Map.
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F3
A follow-up MRI-scan of the brain 5 weeks after the initial event showed, in addition to the known changes of the basal ganglia, a symmetrical, extensive increased FLAIR-signal with correlating marked diffusion restrictions of the white matter, primarily in the fronto-parietal regions of both hemispheres (Figure 3).
Slightly T2w hyperintense signal changes of the white matter (A) without diffusion restriction (B,C), Atophy of the parenchyma with slightly wider inner CSF. 3 T Philips Ingenia, (A) FLAIR, (B) b1000 Figure, (C) ADC Map. Overall there is a marked regression of the imaging findings.
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F4
A slight symmetrical enlargement of the ventricles could be seen indicating a mild atrophy (Figure 4).