Extensive increased T2 signal seen in the periventricular white matter extending to the subcallosal white matter but sparing the subcortical u-fibres. This is associated with volume loss and ex-vacuo dilatation of the ventricles. There is a frontal lobe predominance, although the parietal and temporal periventricular white matter is also involved. The changes are confluent and involve the splenium. The corpus callosum is also thinned. Cerebral blood volume is decreased to the periventricular white matter.
No diffusion restriction detected. No abnormal focus of susceptibility artefact.
MR spectroscopy demonstrated elevation of myo-inositol and choline with relatively preserved NAA.