Bilateral basal ganglia and thalamic T1 hyperintensities

Case contributed by Bahman Rasuli
Diagnosis almost certain

Presentation

Headache. No underlying disease.

Patient Data

Age: 55 years
Gender: Female

Bilateral symmetrical T1W hyperintensities in basal ganglia and thalami.

High signal foci on T1 sequences at centrum semiovale, subcortical, and periventricular white matter of both cerebral hemispheres.

High signal foci on T2 and FLAIR sequences at subcortical and periventricular white matter of both cerebral hemispheres depict microvascular ischemic events.

Case Discussion

There are many causes of basal ganglia T1 hyperintensity, but the majority relate to deposition of T1-intense elements such as calcium, hepatic failure, toxins/ischemia, blood, Japanese encephalitis, and hamartoma in type I neurofibromatosis. The etiology in this case is unknown.

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