A 64-year-old man with a history of diabetes and hyperlipidemia, admitted with COVID-19–related hypoxemic respiratory failure and worsening septic shock. Axial DWI (A–C) and ADC images (D–F) show extensive, bilateral, predominantly symmetric, DWI-hyperintense signal in the white matter of the bilateral middle cerebellar peduncles, corona radiata, and centrum semiovale, with corresponding dark signal intensity on the ADC images (yellow arrows), reflecting leukoencephalopathic changes with marked, confluent reduced diffusivity.