Bilateral symmetric hyperintensities involving the caudate head, globus pallidus, putamen and posterior medial thalami which have associated diffusion restriction and possible further involvement of the mesial cortex of the superior frontal gyri. Subtle hyperintensity involving the insular subcortical white matter. No micro-haemorrhage.
In an appropriate clinical context, this pattern is very suggestive of sporadic CJD. Toxic or metabolic aetiologies are considered less likely.