Rapid memory loss last 3 months. Past history of right eye rhabdomyosarcoma ? brain metastatic disease.
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Multifocal areas of asymmetrical diffusion restriction involving the cortex of bilateral frontal, parieto-occipital and temporal lobes. This is associated with subtle T2/FLAIR hyperintensity. There is no obvious involvement of the white matter. No blooming artefacts on GRE images to suggest blood products.
There are very few differential diagnosis of this disease pattern, and in the absence of an acute event and lack of any underlying known systemic disease, CJD is most likely. The diagnosis was confirmed by biopsy.
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