Periaqueductal hyperintensities: neuromyelitis optica
Patient a known case of neuromyelitis optica, on follow up, with significant improvement. Now presented with complaints of ataxia. Patient was referred to MRI to look for any new lesions.
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MRI brain study revealed peri-aqueductal hyper-intensities in T2 and FLAIR images with minimal diffusion restriction. No new focal lesions were detected. The optic nerve was relatively normal in present study. Spine MRI for follow up was also done which also did not reveal any focal lesions.
A case of known neuromyelitis optica, for follow up. The periaqueductal hyperintensities which are consistent with aquaporin distribution site is more favourable for neuromyelitis rather than multiple sclerosis.