Figure 1.

(A) MRI of brain with gadolinium, axial view showing enhancement consistent with extensive basilar pachymeningitis, and leptomeningitis. Also seen is hydrocephalus. (B) MRI of cervical spine, T2 -weighted short-tau inversion recovery sequence, sagittal view, with a central intramedullary lesion spanning from C1 through C6 of the cervical spinal cord. (C) MRI of cervical spine, T1 sagittal view with gadolinium shows extensive epidural enhancement. No enhancement of the intramedullary lesion is seen. (D) MRA of head, a reconstruction of the left anterior circulation shows a beading pattern consistent with arteritis. (E) CT of head without contrast, an axial view showing worsening hydrocephalus. (F) Cerebrospinal fluid culture showing thin, hyaline, septate hyphae and barrel-shaped arthroconidia (lactophenol cotton blue stain) consistent with coccidioides.