Findings
- Restricted diffusion involving the bilateral caudate nuclei, putamina, pulvinar nuclei of the thalami, and cerebral cortex
- Patchy T2/FLAIR hyperintensities in the subcortical and periventricular white matter
- No evidence of acute hemorrhage, mass effect, or hydrocephalus
- Bilateral pseudophakia
Diagnosis
Creutzfeldt-Jakob disease (CJD)
Sample Report
Restricted diffusion involving the bilateral caudate nuclei, putamina, pulvinar nuclei of the thalami, and cerebral cortex. This appearance raises particular concern for Creutzfeldt-Jakob disease (CJD) given distribution of findings and reported history of dementia, but many other disease processes could have an overlapping imaging appearance including severe hypoxic-ischemic encephalopathy, toxic/metabolic derangement such as hepatic disease or hypoglycemia, and infectious or inflammatory encephalitis. Recommend correlation with CSF analysis and consideration of repeat imaging for further assessment.
Patchy T2/FLAIR hyperintensities in the subcortical and periventricular white matter, which though nonspecific likely represent sequela of chronic small vessel disease.
No evidence of acute hemorrhage, mass effect, or hydrocephalus.
Discussion