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Radiation leukoencephalopathy

Case contributed by Francis Fortin
Diagnosis almost certain

Presentation

Whole-brain prophylactic radiation therapy 5 years prior. Presents with gradual-onset impaired cognition.

Patient Data

Age: 50 years
Gender: Male

5 years prior, pre-treatment

mri

Mild non-specific predominantly patchy white matter hyperintensities.

5yr post whole-brain radiation

mri

5 years later, marked confluent subcortical T2/FLAIR hyperintensities have appeared. Note also hyperintensities surrounding the dentate nuclei. Cerebral and cerebellar atrophy has also significantly progressed. There are no significant microhemorrhages on gradient echo sequences. Note the typical sparing of U-fibers in radiation-induced leukoencephalopathy.

Case Discussion

Typical appearance with U-fiber sparing of radiation leukoencephalopathy.

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