Demographics:
37 years old, Male
Indication:
Encephalopathy
Findings
- Numerous areas of globular T2/FLAIR hyperintensity in the supratentorial subcortical and periventricular white matter as well as involving the genu of the corpus callosum with lamellated internal architecture and associated incomplete peripheral and concentric internal ring enhancement
- Mild local mass effect without midline shift or herniation
- Sparing of the deep gray nuclei and posterior fossa
- No evidence of acute infarct, hemorrhage, or hydrocephalus
Diagnosis
Balo concentric sclerosis
Sample Report
Findings are consistent with an acute demyelinating process with extensive involvement of the supratentorial brain and sparing of the deep gray structures and posterior fossa. The imaging appearance is classic for Balo concentric sclerosis but could also represent tumefactive multiple sclerosis or acute disseminated encephalomyelitis (ADEM).
Mild associated mass effect without midline shift or herniation.
No evidence of acute infarct, hemorrhage, or hydrocephalus
Discussion