Cranial MRI (magnetic resonance imaging) showed bilateral millimetric subacute diffusion restriction in the bilateral centrum semiovale
(CS) on the series of diffusion-weighted imaging (DWI) [Figure 1].
((a) and (b)) On admission, DWI or T2 sequences of MRI showed hyperintense signal intensity in the right centrum semiovale
and hyperintense lacunar lesions adjacent to the left lateral ventricle.
The imaging findings of patients 2 and 5 showed no progress compared with their initial MRI, but in patient 6, MRI revealed an expansion of the supratentorial area and loss of edema in the thalamus and centrum semiovale
Abnormal signal intensity area is noted in periventricular white matter and centrum semiovale
on right side in territory of right MCA appearing hyperintense on T2WS and FLAIR sequences suggesting chronic infarct with gliosis.
Caption: FIGURE 4: The deep white matter of the centrum semiovale
bilateral demonstrates high signal intensity changes at Flair axial MR imaging.
Head CT (computed tomography) showed a left centrum semiovale
round hypodense lesion measuring 1.4 cm, a left basal ganglia round hypodense lesion measuring 1.0 cm and a left occipital lobe round hypodense lesion measuring approximately 1.0 cm (Figure 1).
Cranial magnetic resonance imaging (MRI) revealed atrophy of the brain stem, pontine punctate hyperintensities on T2 weighted images, also bilateral T2 hyperintensities in centrum semiovale
, and corpus callosum.
Fahr's disease (FD) is characterized by sporadic or familiar idiopathic calcification of the basal ganglia, dentate nuclei of the cerebellum, and centrum semiovale
The ROIs were placed bilaterally (except for the corpus callosum) at the following anatomical locations: the posterior limb of the internal capsule, the centrum semiovale
anterior, the posterior corona radiata anterior and posterior, the splenium and the genu of the corpus callosum, the thalamus, and the caudate nucleus (Figure 1).
In MPS, these diffusely enlarged PVS affect the periventricular WM, corpus callosum, basal ganglia, subcortical WM, centrum semiovale
, thalami and brain stem, resulting in the cribriform or spindle-like pattern.
Brain MRI confirmed lacunar infarcts in the centrum semiovale
bilaterally and bilateral watershed territory infarcts suggestive of a vasculopathy.
It is well established that the primary cause of hemiparesis following hemispheric stroke is damage to the motor cortex or the white matter pathways in the centrum semiovale
, periventricular white matter (PVWM), or the posterior limb of the internal capsule linking this cortex to the brain stem and spinal cord [1-10].