Axial MRI of a 46 year old man with secondary progressive MS showing a large left sided periventricular lesion which is hyperintense with (A) T2 weighted.

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Axial MRI of a 46 year old man with secondary progressive MS showing a large left sided periventricular lesion which is hyperintense with (A) T2 weighted imaging and hypointense with (B) T1 weighted imaging (“black hole”). Axial MRI of a 46 year old man with secondary progressive MS showing a large left sided periventricular lesion which is hyperintense with (A) T2 weighted imaging and hypointense with (B) T1 weighted imaging (“black hole”). S A Trip, and D H Miller J Neurol Neurosurg Psychiatry 2005;76:iii11-iii18 ©2005 by BMJ Publishing Group Ltd