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FIG 3. Patient 3 had steroid-induced IDDM and presented during induction. Initial strokelike event was associated with aphasia and right hemiparesis and hemisensory loss, which resolved. Second event occurred 8 weeks later and was associated with aphasia, left hemiparesis, and focal seizure, all of which resolved.
A and B, DW image (A) and ADC map (B) at initial presentation show large areas of restricted diffusion in the centrum semiovale (arrows). Bilateral diffusion abnormalities were associated with unilateral hemimotor-sensory deficit.
C and D, Axial FLAIR images obtained 8 weeks later shows extensive presumed demyelination in deep white matter. Note absence of abnormal signal intensity in the right parietal region.
E and F, Axial DW image (E) and ADC map (F) show restricted diffusion in the right parietal cortex and subcortical white matter. Diffusion abnormalities were correlated with left hemiparesis and left focal seizure. Hyperintensity in the left anterior centrum semiovale (arrow in E) is due to T2 shine-through; ADC map shows a corresponding area of hyperintensity (arrow in F).
G, Axial FLAIR image obatined 28 months later when the patient was asymptomatic shows more-extensive white matter abnormalities. Note absence of gliosis in the right parietal region.
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