Figure 1 Axial FLAIR brain MRI obtained on admission to the ICU demonstrated (A1) old hyperintense subcortical lesions (arrowhead), new superimposed on.

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Presentation transcript:

Figure 1 Axial FLAIR brain MRI obtained on admission to the ICU demonstrated (A1) old hyperintense subcortical lesions (arrowhead), new superimposed on old T2/FLAIR hyperintense juxtacortical lesions (A.a arrow), and new lesions (A.b arrow), none of which demonstrated gadolinium enhancement or diffusion restriction. Axial FLAIR brain MRI obtained on admission to the ICU demonstrated (A1) old hyperintense subcortical lesions (arrowhead), new superimposed on old T2/FLAIR hyperintense juxtacortical lesions (A.a arrow), and new lesions (A.b arrow), none of which demonstrated gadolinium enhancement or diffusion restriction. Parts B-E are follow-up images, please refer to the text for clinical context. Follow-up brain MRI obtained after the patient deteriorated demonstrated a T2 hyperintensity in the ventral-rostral medulla, on axial (arrow, B), and coronal cuts (arrow, C), that was hypointense on T1 sagittal imaging, with a very faint rim enhancement on post-gadolinium sequences (arrowhead E; enhancement, and not well visualized on this image). There were also T2 hyperintense lesions on axial sequences in the caudal medulla (arrows, D), one of which enhanced with gadolinium on the T1 sagittal view (arrow, E). Michael J. Bradshaw et al. Neurol Neuroimmunol Neuroinflamm 2019;6:e526 Copyright © 2018 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.