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Case #27

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Demographics: 17 years old, Female
Indication: Encephalopathy

Case #27

Findings

  • T2/FLAIR signal hyperintensity in the right greater than left thalami and right greater than left dorsal midbrain with involvement of the periaqueductal gray matter, hypothalamus, anterior commissure, and mamillary bodies
  • Areas of cystic change in the right thalamus and right eccentric midbrain
  • No corresponding enhancement or restricted diffusion
  • No substantial intracranial mass effect or evidence of hydrocephalus

Annotated Images & Illustrations

FLAIR signal hyperintensity along the ependymal margins of the third ventricle and cerebral aqueduct, extending into the right greater than left thalami.

FLAIR signal hyperintensity along the ependymal margins of the third ventricle and cerebral aqueduct, extending into the right greater than left thalami.

FLAIR signal hyperintensity along the ependymal margins of the third ventricle and cerebral aqueduct, extending into the right greater than left thalami.

FLAIR signal hyperintensity along the ependymal margins of the third ventricle and cerebral aqueduct, extending into the right greater than left thalami.

Diagnosis

Neuromyelitis optica (NMO)

Key Imaging Features

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Differential Diagnosis

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Discussion

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Pearls

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References

  • Dutra BG, da Rocha AJ, Nunes RH, Maia ACM. Neuromyelitis optica spectrum disorders: Spectrum of MR imaging findings and their differential diagnosis. Radiographics 2018; 38(1): 169-193.

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