Extensive white matter abnormalities, in both cerebral hemispheres with prominence in the periventricular areas and asymmetric appearance (more in the left frontal lobe). In addition, severe involvement of the genu of the corpus callosum and extension through the capsules into both cerebral peduncles.
Geographic enhancement around the white matter changes.
MR spectroscopy shows elevation of the choline peak, particularly at the deep parietal white matter and diffuse decrease of NAA peak. In general, findings are in keeping with active demyelination.
Overall, MR findings are consistent with multifocal/diffuse demyelination, similar to that in adrenoleukodystrophy.