Figure Leptomeningeal inflammationPostcontrast T1-weighted MRI: abnormal leptomeningeal enhancement over the frontoparietal lobes and interhemispheric.

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Figure Leptomeningeal inflammationPostcontrast T1-weighted MRI: abnormal leptomeningeal enhancement over the frontoparietal lobes and interhemispheric fissure before (A, C, E) and after (B, D, F) 3-month methotrexate treatment. Leptomeningeal inflammationPostcontrast T1-weighted MRI: abnormal leptomeningeal enhancement over the frontoparietal lobes and interhemispheric fissure before (A, C, E) and after (B, D, F) 3-month methotrexate treatment. Histopathology (G and H): necrotizing granulomas involving the leptomeninges surrounded by mononuclear inflammatory cells and focal giant cell reaction (arrow) without signs of vasculitis. Hematoxylin & eosin stains (×4, ×20). Simona Lattanzi et al. Neurol Neuroimmunol Neuroinflamm 2014;1:e43 © 2014 American Academy of Neurology