Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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Presenting CT demonstrated patchy foci of white matter low density (not shown), which precipitated MRI. A, Axial T2 with multifocal patches of cerebral white matter signal change predominantly involving lobar white matter. B, Axial gradient-echo image shows a few foci of microhemorrhage (oval). C, Multifocal areas of restricted diffusion correlating to some areas but also remote from microhemorrhage. D, Axial SWI demonstrates more conspicuous extensive microhemorrhage. E and F, Gadolinium-enhanced T1 shows extensive leptomeningeal enhancement with a few nodular foci; there is sparing of the skull base and no cerebellar or cranial nerve involvement. The patient subsequently underwent brain biopsy.