Volume 8, Pages (September 2017)

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Volume 8, Pages 28-30 (September 2017) Longitudinal clinical and neuro-radiological findings in a patient with leukoencephalopathy with brain calcifications and cysts (Labrune syndrome) Yasushi Iwasaki, Ken-ichiro Hoshino, Keiko Mori, Masumi Ito, Yoshinari Kawai, Maya Mimuro, Tamao Tsukie, Takeshi Ikeuchi, Mari Yoshida eNeurologicalSci Volume 8, Pages 28-30 (September 2017) DOI: 10.1016/j.ensci.2017.07.003 Copyright © 2017 The Authors Terms and Conditions

Fig. 1 Longitudinal head CT findings. (A) At the age of 50years, the patient exhibited several calcifications in her basal ganglia and lateral ventricular dilatation with moderate leukoencephalopathy but no apparent cyst formation. (B) At the age of 56years, she exhibited a small high-signal region in the leukoencephalopathy area of the left frontal lobe (arrow) that we suspected was a small haemorrhage. (C) At the age of 57years, she exhibited cystic formation within the small high-signal area in B (arrow) with some intra-cyst bleeding. A distinct low-density area in the right corona radiata was also observed (arrowhead). (D) At the age of 58years, she exhibited a small high-signal region in the leukoencephalopathy area of the right temporo-parietal lobe (arrow) that we suspected was a small haemorrhage. (E) At the age of 59years, she exhibited a small low-density area within the small-high signal area in D (arrow). (F) At the age of 60years, she developed a large cystic formation in the right temporo-parietal lobe. (G) When she was 61years old, we observed bleeding in her cyst in F. These CT scans obtained over 10years revealed progressive ventricular dilatation and expansion of the leukoencephalopathy but no apparent changes in the intracranial calcifications. Abbreviations: CT, computerised tomography; R, right side. eNeurologicalSci 2017 8, 28-30DOI: (10.1016/j.ensci.2017.07.003) Copyright © 2017 The Authors Terms and Conditions

Fig. 2 Head MR imaging findings obtained at the age of 60years. (A) T2-weighted imaging revealed 2 cysts with clear boundaries and extensive leukoencephalopathy. (B) Susceptibility-weighted imaging revealed numerous bleeds of various size. (C) Diffusion-weighted imaging revealed several high-signal regions. (D) MR angiography of the intracranial arteries revealed wall irregularities and stoppage, particularly on the right side. Abbreviations: MR, magnetic resonance; R, right side. eNeurologicalSci 2017 8, 28-30DOI: (10.1016/j.ensci.2017.07.003) Copyright © 2017 The Authors Terms and Conditions

Fig. 3 Head CT findings obtained at the age of 61years. Cerebral haemorrhage was incidentally found in the right occipital lobe during a regular follow-up scan. Abbreviations: CT, computerised tomography; R, right side. eNeurologicalSci 2017 8, 28-30DOI: (10.1016/j.ensci.2017.07.003) Copyright © 2017 The Authors Terms and Conditions