CNS VZV–IRIS (same patient as in Fig 3).

Slides:



Advertisements
Similar presentations
Images of a 51-year-old woman (patient 8) with generalized tonicoclonic status epilepticus. Images of a 51-year-old woman (patient 8) with generalized.
Advertisements

Anti-Hu encephalitis. Anti-Hu encephalitis. A 68-year-old man with chronic obstructive pulmonary disease presented with gradually worsening memory deficits.
Axial T1-weighted image after contrast administration (A) and a FLAIR image (B) demonstrating a left parietal subcortical DVA with deep venous drainage.
Anti-N-methyl D-aspartate receptor encephalitis.
Patient 1. Patient 1. A 40-year-old man with mild ataxia and homonymous hemianopia. CRP level was initially 0.5 mg/dL and did not change in the clinical.
A–C, Case 1. A–C, Case 1. Typical white matter changes involving the corpus callosum and the pyramidal tracts (A and C, arrows), dilation of the lateral.
Photograph, CT, and MR imaging of the patient.
(cont'd) G, Post-treatment diffusion-weighted image of the same slice as in C showing an area of persistent, although smaller, signal abnormality in the.
Images at the level of the basal ganglia and sylvian fissure in a patient with hyperintensity on FLAIR images.A, Contrast-enhanced FLAIR image shows increased.
Patient 8. Patient 8. Neonate of estimated 39-week gestational age with a lacerated, prolapsed umbilical cord. A, Axial T2-weighted fast spin-echo image.
Serial imaging of a child with a clinical complex of bilateral facial PWS, early-onset severe seizures, and fatally progressive encephalopathy. Serial.
Patient 1, a 15-day-old neonate who presented with encephalopathy
Axial view MR images of the head, obtained at the time of second presentation.A, T1-weighted MR image (400/15) shows thickening of the dura overlying the.
A 50-year-old woman with fever and severe hypertension.
RCVS. RCVS. A, Axial brain CT scan shows bilateral frontoparietal sulcal SAH (white arrowheads). B, Axial FLAIR image confirms the cSAH (white arrowheads).
Patient 1. Patient 1. A 24-year-old woman with complicated (cardiac failure, pulmonary edema, chest infection, sternal wound sepsis, and venous thrombosis)
Patient 9. Patient 9. A 31-year-old man with mental status changes and seizure activity.A, T2-weighted axial MR image shows bilateral frontal and right.
A 21-year-old woman with SLE, lupus nephritis, and difficult-to-control hypertension presented with headache and change in vision progressing to generalized.
Axial CT image (A) in a patient with behavioral variant frontotemporal dementia shows a marked frontal atrophy, and axial perfusion SPECT images (B) show.
Patient 16 is a 39-year-old woman status post bowel resection and appendectomy for Crohn disease being maintained on antibiotics and steroids with baseline.
Hashimoto encephalitis.
A, In a patient with a history of breast cancer surgery and radiation treatment with right-arm weakness, axial T2WI shows diffuse thickening of the right.
Anti-glutamic acid decarboxylase encephalitis.
Another patient with intraspinal abnormalities
Patient 6: 24-year-old woman with primary angiitis of the CNS
Axial MR image (TR/TE, 10,002/142) obtained when the patient was aged 5 days shows extensive areas of abnormal signal intensity, which suggest edema involving.
Axial MR image (10,002/142) obtained when the patient was aged 12 days demonstrates ventricular size and sulcal prominence have increased since the study.
A, Axial T1-weighted (700/17/1) MR image shows mild asymmetry of the lower basis pontis and middle cerebellar peduncle on the left. A, Axial T1-weighted.
Supratentorial and posterior fossa PML
Involvement of the frontal and parietal lobes in patients with isolated cortical hyperintensities. Involvement of the frontal and parietal lobes in patients.
T2-weighted, PD-weighted, FLAIR, and DWI images showing cortical abnormalities in the right parietal lobe; FLAIR and DWI also show abnormalities in the.
Images in a 49-year-old women with leptomeningeal carcinomatosis from adenocarcinoma of the lung. Images in a 49-year-old women with leptomeningeal carcinomatosis.
Coronal (A) and axial (B) contrast-enhanced T1-weighted MR images and an axial DWI (C) and ADC map (D) in a patient with primary dural B-cell lymphoma.
A, FLAIR demonstrating acute infarct within a superficial distribution
Coronal T2 (A) and axial TI FLAIR (B), ADC (C), and T2 (D) MR images of a 21-day-old boy. Coronal T2 (A) and axial TI FLAIR (B), ADC (C), and T2 (D) MR.
Coronal T2 (A), axial T1 (B), ADC (C and D), and SWI (E and F) MR images of a 7-day-old girl. Coronal T2 (A), axial T1 (B), ADC (C and D), and SWI (E and.
Axial T2-weighted MR images
Contrast-enhancing lesions on CT scans (A–D) in 4 patients with AIDS-related PCNSL. Note irregularly enhancing lesions in the right parietal lobe (A),
Patient 4: 71 year-old woman with primary angiitis of the CNS
Signal characteristics of PML
A, On day 9 of illness, MRA of the circle of Willis demonstrates normal caliber of the ICAs, MCAs, ACAs, and vertebrobasilar system. A, On day 9 of illness,
A–C, Sagittal T1-weighted (A), sagittal T2-weighted (B), and axial T2-weighted (C) MR images of the cervical spine in a patient with severe myelopathy.
Patient 2. Patient 2. A 31-year-old man with fever, seizures, and weakness of the left upper extremity. DW images were superior to conventional MR images.
Anti-voltage-gated calcium channel encephalitis.
Patient with intraspinal abnormalities
Patient 1. Patient 1. Axial fluid-attenuated inversion recovery (FLAIR) imaging (A), diffusion-weighted imaging (DWI) (B), and apparent diffusion coefficient.
1, Axial T2 image in patient 1 demonstrates bilateral cystic spaces in the biparietal periventricular white matter. 2, Axial T2 image in patient 2 demonstrating.
A 47-year-old woman with a history of alcohol abuse presented with ataxia, changes in consciousness, and ocular abnormalities. A 47-year-old woman with.
A 34-year-old woman with SLE with APS
Sequential diffusion-weighted images show bright basal ganglia as the initial finding after anoxia. Sequential diffusion-weighted images show bright basal.
Coronal T2 (A) and axial T1 FLAIR (B), T2 (C), and SWI (D) MR images of a 6-day-old boy. Coronal T2 (A) and axial T1 FLAIR (B), T2 (C), and SWI (D) MR.
MR images of the brain (axial sections, fluid-attenuated reversion recovery sequences) show the symmetric hyperintensities (arrows) involving the pyramidal.
A 43-year-old male patient with headaches (case 33).
A 61-year-old woman with RCVS
Typical disease course of cPML in an HIV-positive patient receiving HAART. Top panel, a set of images at presentation with focal diffusion restriction.
Axial T2-weighted image (A) demonstrates focal cortical dysplasia (arrow) centered in the left anterior temporal lobe in a right-handed patient. Axial.
Anti-voltage-gated calcium channel cerebellitis.
A 42-year-old woman who presented with altered mental status and lethargy. A 42-year-old woman who presented with altered mental status and lethargy. FLAIR.
 MR imaging findings of clear-cell meningioma with diffuse leptomeningeal seeding in 17-year-old man.  MR imaging findings of clear-cell meningioma with.
A, Axial T2-weighted image (3500/90/2) shows a well-defined deep right occipital white matter lesion (asterisk) and a subcortical linear hyperintensity.
Coronal T2 (A) and sagittal T1 (B), axial T2 (C), and axial ADC (D and E) MR images of a 12-day-old boy. Coronal T2 (A) and sagittal T1 (B), axial T2 (C),
A, Axial T1- weighted MR image shows a predominantly isointense lesion in the right parietal bone. A, Axial T1- weighted MR image shows a predominantly.
Patient 2. Patient 2. Additional MR images.A–C, Follow-up image (A) obtained 15 days after surgical intervention shows reduced size of the abscess cavity.
Persistent diffusion abnormalities in the brain stem of patient 2.
Case 2: 52 year-old man with intracranial injuries sustained in a motor vehicle accident. Case 2: 52 year-old man with intracranial injuries sustained.
Visible atrophic changes after moderate TBI
Isolated restricted diffusion in a patient who recovered without residual symptoms.A, DW image shows asymmetric (right greater than left) high signal intensity.
Images in a 50-year-old man with empyema and chronic meningitis.
Chronic CNS-IRIS without coinfection.
Marked progression of PML documented by serial MR studies
Presentation transcript:

CNS VZV–IRIS (same patient as in Fig 3). CNS VZV–IRIS (same patient as in Fig 3). Initial MR imaging of the brain shows, on axial FLAIR (A and B) and contrast T1WI (C and D), bilateral hyperintense signal abnormalities without restricted diffusion in the cortical and subcortical regions of the occipital, temporal, frontal, and parietal lobes with leptomeningeal and some patchy adjacent parenchymal enhancement with mild sulcal compression and no MRA (not shown) abnormalities. She was restarted on HAART and finished a 3-week course of acyclovir followed by suppressive therapy. Follow-up MR imaging 1 year later (E–H) shows a marked decrease in FLAIR (E and F) high-signal abnormalities with concomitant atrophy and near resolution of the leptomeningeal and parenchymal areas of enhancement, shown on axial contrast images (G and H). M.J.D. Post et al. AJNR Am J Neuroradiol 2013;34:1308-1318 ©2013 by American Society of Neuroradiology