FIG 2. Case 3. Sample case in which cerebral cortices were involved mainly in the early stage.

A and B, At 1 month from the onset of symptoms, FLAIR imaging (A) reveals only subtle changes, whereas diffusion-weighted imaging (B) reveals hyperintense lesions in the cerebral cortices with a faint left striatal lesion. Note that the left striatum is asymmetrically involved (the right striatum is spared), and the anterior portion of the left putamen appears hyperintense compared with the posterior portion (arrowhead in B).

C, At 3 months from onset of symptoms, diffusion-weighted imaging reveals not only cortical lesions but also diffuse bilateral striatal lesions (arrowheads). Note that the left putaminal lesion spread posteriorly and entirely, as compared with its appearance in B.