Neuro case 03

Case courtesy of Dr Anas

5yo Fever and vomitting for 9 days. H/O prolonged cough.

Description
MRI Brain

Findings
There are multiple bilateral asymmetrical subcortical white matter T2/FLAIR hyperintensities at both cerebral hemispheres and cerebellum. Corresponding T1 hypointense changes identified. No significant diffusion restriction. Subtle patchy enhancement demonstrated post gadolinium. There are also signal changes in bilateral thalami, putamina and hippocampi as well as the corpus callosum, without diffusion restriction nor enhancement.
No blooming artifact to suggest hemorrhage.
No abnormal leptomeningeal enhancement.
Ventricles and extra-axial spaces are within normal limits.

Impression:
Features are in keeping with Acute disseminated encephalomyelitis.

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