Case #18

CT

• Areas of hypoattenuation in the anterior right basal ganglia/anterior limb of the right internal capsule and in the right frontal subcortical white matter with mild corresponding local mass effect

MRI

• Multifocal areas of parenchymal restricted diffusion involving the bilateral cerebral and cerebellar hemispheres
• The largest lesion is located in the anterior right basal ganglia/anterior limb of the right internal capsule, which measures 3 x 2.5 x 2.3 cm, demonstrates peripheral enhancement which is incomplete along its ependymal margin, and demonstrates central restricted diffusion
• Linear enhancement extends along the superior margin of the right lateral ventricle
• Many of these lesions demonstrate peripheral susceptibility artifact
• Surrounding vasogenic edema, particularly involving the right basal ganglia and right frontal subcortical lesions
• No substantial midline shift or evidence of herniation or hydrocephalus