Presentation
Headaches and memory loss in a young patient.
Patient Data
MRI shows subtle abnormal signal intensity in the basal ganglion, particularly evident within the caudate nucleus.
The basal ganglia are hyperintense on DWI (not shown, but hypointense on ADC) & slightly hyperintense on T2. As mentioned previously, this is more evident with regard to the caudate nucleus. There is no abnormal cortical signal or diffusion restriction.
Case Discussion
There is a broad differential diagnosis for T2 basal ganglia hyperintensities.
However, the diagnosis of Creutzfeldt-Jakob was confirmed a few weeks after the MRI was done. DWI is the most sensitive sequence for this disease.