There is extensive, supratentorial, multifocal, bilateral, fluffy, temporal, frontoparietal, and subcortical high signal intensity on T2 and T2 FLAIR imaging. There is low signal intensity on T1 imaging. There is an avid, irregular enhancement of these lesions on contrast administration. There is some restricted diffusion along the peripherally of the lesions with corresponding reduced average diffusivity on ADC mapping, however, the predominant appearance on ADC is of T2-shine through. The basal ganglia, thalami, brainstem and cerebellar hemispheres are spared. SWI is normal. The optic nerves are tortuous however no abnormal optic/ perioptic or retrobulbar fat enhancement is noted. There is a normal optic chiasm and retrochiasmatic pathway. The TOF MRA is normal.
Case courtesy: Dr VKS. Bhagwandas