Fig. 7.

A 44 year old male presented with an altered and decreased level of consciousness for 2–3 days following a reported large amount of “crack” cocaine inhalation, which caused ATL. An initial MRI demostrated bilateral, symmetric reduced diffusion throughout the PVWM (arrows) on DWI MRI (A) and ADC map (B), also with PVWM hyperintensity on FLAIR (C). Four months later, the areas of reduced diffusion within the PVWM evolved into predominantly “T2 shine-through” (i.e. bright on ADC), as shown on DWI MRI (D), ADC map (E), and FLAIR (F).