Presentation
Left hemiparesis, headaches and cognitive decline
Patient Data
Age: 20 years
Gender: Female
From the case:
Baló concentric sclerosis
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There are multiple subcortical, periventricular, pericallosal and callosal (genu and splenium) T2W/FLAIR hyperintense lesions giving (Dawson fingers) appearance, the largest seen in the right centrum semiovale showing concentric areas of alternating signal intensities with a ring of diffusion restriction measuring about 22 x 25 mm.
Patchy restricted diffusion seen in lesions of the splenium of corpus callosum.
Case Discussion
Baló concentric sclerosis is a variant of multiple sclerosis with alternating intralesional intensities giving a 'bullseye' or 'onion bulb' appearance.
The regions of true diffusion restriction reflect active demyelination.