Fig 1.

Progression of a GP infarct. This 16-month-old patient was known to have MMA due to the cblB defect that had been diagnosed 6 months previously. Within 24 hours after onset of symptoms from gastroenteritis, she became lethargic and was taken to the emergency department. A, CT at the time of admission to the hospital appears to have normal findings. B, CT scan 35 hours later shows distinct hypoattenuating abnormalities involving the entirety of each GP. DWI performed 1 week later showed restricted diffusion in each GP (image not available). C, High-resolution MPRAGE image and D, T2-weighted image (b=0 image from DTI) acquired 7.5 years later demonstrate bilateral complete GP infarcts.