Amyotrophic lateral sclerosis
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Increased T2 signals in posterior limb of bilateral internal capsules, tracking superiorly to subcortical white matter of motor cortex and inferiorly along corticospinal tracts.
This patient presented with clinical amyotrophic lateral sclerosis subsequently confirmed. It is important to recognize, however, that slight increase in T2 signal is common in the corticospinal tracts and thus one should not over-call subtle change.