Section Editor: Sandy Cheng-Yu Chen, M.D.
Taipei Medical University Hospital, Taipei, Taiwan
CNS cryptococcal infection tends to cause Virchow-Robin space dilatation, which may show T1 hypointensity (A, arrows), no enhancement after gadolinium administration (B, arrows), hyperintensity in T2 FLAIR (C, arrows), and restricted water diffusion on DWI (D, arrows). The restricted diffusion is due to the high viscosity of the “gelatinous” material that fills these spaces, producing the characteristic perivascular pseudocysts of cryptococcal infection. The pseudocysts are usually symmetrical and located in the basal ganglia, thalamus, brainstem, and, as in our case, the internal capsule.