Fig. 1.

Baseline MRI in a 14-year-old boy with progressive cognitive decline, behavioral changes, and left hemiparesis. Axial FLAIR image demonstrates FLAIR hyperintense lesions in the bilateral basal ganglia (A) with associated signal abnormality on axial SWI image indicating iron or hemosiderin (B). The right basal ganglia lesion demonstrates abnormal contrast enhancement on axial postcontrast T1 images (C). There is evidence of right cerebral volume loss (arrows in D) and abnormal signal and volume loss in the right pons (arrows in E) on axial T2 images. No suprasellar or pineal region lesions were present on sagittal postcontrast T1 images (F). MRI, magnetic resonance imaging; SWI, susceptibility weighted imaging.