Presentation
Known case of diabetes mellitus and hypertension presents with an altered level of consciousness.
Patient Data
There is an area of diffusion restriction is seen in the right basal ganglia and in adjacent periventricular white matter showing signal drop out on corresponding ADC images representing acute ischaemic infarction. Extensive bilateral symmetric Virchow Robin spaces within bilateral basal ganglia and white matter of both cerebellar hemispheres reaching up to high vertex giving 'swiss cheese' appearance of the brain.
Case Discussion
État criblé is a term that is described by the diffuse widening of Virchow-Robin spaces in the basal ganglia, and the corpus striatum. These spaces appear symmetrical, with the perivascular spaces showing high T2 signal and no diffusion restriction.
Additional contributor: Dr Subhan Iqbal