Presentation
Right hemiparesis since a few days
Patient Data
Irregular T2/FLAIR hyperintensity is seen in left corona radiata extending to internal capsule, left cerebral peduncle and left lateral aspect of pons.
T2/FLAIR hyperintensities are also seen involving right frontal cortex / subcortical white matter, right corona radiata and bilateral cerebellar hemispheres.
No obvious diffusion restriction or enhancement on post contrast study is seen.
Focal non specific nodular enhancement is seen in right thalamus.
Case Discussion
On probing, the patient was found to be HIV positive with low CD-4 counts. In this context, above findings are suggestive of progressive multifocal leukoencephalopathy.
The patient also had abdominal tuberculosis. The nodular enhancement in right thalamus is non-specific. However, close follow-up is advised for CNS tuberculosis.
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