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. 2020 Jan 10;62(3):283–300. doi: 10.1007/s00234-019-02335-5

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© The Author(s) 2020

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Fig. 4 — Leptomeningeal enhancement. a A 35-year-old male affected by skin biopsy–proven neurosarcoidosis. Axial post-contrast T1-weighted MRI at the level of the basal ganglia shows extensive parietal leptomeningeal enhancement (arrow), more evident on the right side, with multiple miliary-enhancing nodules with a distribution pattern suggestive of PVS involvement in the left occipital lobe (arrowhead). The same patient also shows extensive irregular leptomeningeal enhancement at the level of the cervical spinal cord. b A 26-year-old female with neurotuberculosis. Axial post-contrast T1-weighted MRI at the level of the 4th ventricle demonstrates an extensive leptomeningeal involvement at the ventral pons, fifth cranial nerves (arrows) and the petroclinoid ligaments. Note the non-PVS pattern of the miliary nodules scattered at random throughout the temporal lobes and cerebellum. Note the 4th ventricle dilatation, caused by secondary hydrocephalus due to the extensive basilar leptomeningeal involvement. c A 37-year-old female with cranial nerve VII neuritis due to Lyme disease. Axial magnification of the cerebellopontine angle post-contrast T1-weighted MRI shows intense contrast enhancement of the cisternal segment of the right facial nerve (arrow)