Fig. 1.

MRI brain performed 2 months after the initial presentation (a–d) and subsequent MRI brain 1 year after diagnosis and treatment (e–h).

MRI of the brain performed 2 months following the onset of symptoms (a–d) revealed abnormal signal of the head and body of the caudate nuclei (arrows) and the putamen (open arrows) on T2 (a) and FLAIR (b) axial images. There was a subtly increased signal in these regions on DWI (c), with the ADC maps (not shown) suggesting T2 shine through (subacute to chronic) rather than acute diffusion restriction. There was no lactate shown on intermediate TE (d) or short TE single-voxel MRS (not shown). Sequential MRI performed 1 year after diagnosis and treatment (e–h) showed no change in T2 (e), FLAIR (f), or DWI (g) signal. There was no change in spectroscopy (h).