MICROSCOPIC DESCRIPTION: Sections show white matter, within which there is patchy areas within which here appears to be myelin loss in association with a moderately florid neutrophilic infiltrate which in areas is perivascular centric in association with red cell extravasation and scattered reactive changes in oligodendrocytes. No viral inclusions are identified. There is no significant lymphocytic infiltrate.

DIAGNOSIS: Deep white matter - features in keeping with acute hemorrhagic leucoencephalitis within the early stage of the spectrum of acute demyelinating encephalomyelitis (ADEM).