PMC4925684_01
Case one, 2008: Fluid attenuated inversion recovery (FLAIR) MRI sequences showing multifocal hyperintensity in the subcortical U-fibres of the right basifrontal, right temporal, and left parieto-occipital regions (see arrows). The corresponding T1 post contrast images (lower row), demonstrate an absence of enhancement
13365_2015_419_Fig1_HTML.jpg
PMC4925684_01_13365_2015_419_Fig1_HTML.jpg
Fig1
Annual MRI brain scans since 2008 (Figs. 1, 2 and 3) showed progressive white matter atrophy, and since 2010 asymptomatic fluctuating contrast enhancement without mass effect, in both cortical grey and subcortical white matter.
Case one, 2011: FLAIR MRI sequences from 2011 again show hyperintensity in the right basifrontal (see arrows) and left parieto-occipital regions, now with enhancement on corresponding post contrast T1 images (lower row) in the right basifrontal region only
13365_2015_419_Fig2_HTML.jpg
PMC4925684_01_13365_2015_419_Fig2_HTML.jpg
Fig2
Annual MRI brain scans since 2008 (Figs. 1, 2 and 3) showed progressive white matter atrophy, and since 2010 asymptomatic fluctuating contrast enhancement without mass effect, in both cortical grey and subcortical white matter.
Case one, 2013: FLAIR hyperintensity has increased in the left parieto-occipital region (see arrows, top images), with new gyriform enhancement (see arrows, bottom images) on corresponding pre-contrast FLAIR sequences. The right basifrontal contrast enhancement has shown a complete resolution
13365_2015_419_Fig3_HTML.jpg
PMC4925684_01_13365_2015_419_Fig3_HTML.jpg
Fig3
Annual MRI brain scans since 2008 (Figs. 1, 2 and 3) showed progressive white matter atrophy, and since 2010 asymptomatic fluctuating contrast enhancement without mass effect, in both cortical grey and subcortical white matter. MRI brain showed increased subcortical signal hyperintensity and cortical enhancement in the left posterior temporal lobe extending into the parieto-occipital region (Fig. 3).
PMC4925684_02
Case two, 2006: FLAIR MRI sequences demonstrating multiple poorly defined bright foci in the central and periventricular white matter, with subcortical U-fibre involvement (see arrows) in the frontoparietal region
13365_2015_419_Fig4_HTML.jpg
PMC4925684_02_13365_2015_419_Fig4_HTML.jpg
Fig4
An MRI showed left frontotemporal white matter lesions (Fig. 4).
Case two, 2012: FLAIR MRI sequences showing new lesions in the posterior fossa (see arrow) and an increase in the number of lesions in the high frontoparietal white matter bilaterally (see arrows). There was also increased cerebral atrophy. There was no mass effect, perilesional oedema, or enhancement after contrast administration (not shown)
13365_2015_419_Fig5_HTML.jpg
PMC4925684_02_13365_2015_419_Fig5_HTML.jpg
Fig5