Fig 1. The first row (A) shows axial T2- and T1-weighted images, not obtained in our institution, at the age of 3.5 months. The rows B–D represent MR imaging studies (axial T2-weighted, axial FLAIR, axial T1-weighted precontrast, axial T1-weighted postcontrast) and proton MR spectroscopy studies (long-echo TE, 288; with the voxel placed on the left frontal white matter) performed at our institution at the ages of 8 months, 19 months, and 39 months, respectively. White matter signal-intensity abnormality (high T2-weighted, FLAIR, and low T1-weighted) with frontal predominance involving the arcuate fibers and the external and the extreme capsule is apparent in all studies. The white matter has a swollen appearance in all studies except the last one (D). Basal ganglia symmetric signal-intensity abnormality with patchy appearance involving mainly the caudate and putamen (striatum) is apparent in the first 3 studies. The signal intensity is significantly less in the last study (D). Increasing size of the frontal cavitations is apparent with the subsequent studies. A periventricular rim of high intensity is seen on the T1-weighted images of the studies B–D. Contrast enhancement is less apparent in the last study (D). Spectroscopy results are shown on Table 2.