Focal haemorrhage as atypical feature on MRI in progressive multifocal leukoencephalopathy

Authors

  • Lakshmi Priya Assistant Professor of Neurology, MS Ramaiah Medical College
  • Mahendra Javali Professor of Neurology, MS Ramaiah Medical College
  • Purushottam Acharya Professor of Neurology, MS Ramaiah Medical College
  • Pradeep Rangaiah Associate Professor of Neurology, MS Ramaiah Medical College

DOI:

https://doi.org/10.54029/2024irw

Keywords:

PML, Focal haemorrhage, rim and core pattern, HIV positive

Abstract

Progressive multifocal leukoencephalopathy (PML) is a severe progressive demyelinating disorder caused by the suppression of cell-mediated immunity and is diagnosed by typical imaging features on MRI and confirmed by the identification of the JC virus on CSF. We present a case of HIV positive adult male who presented with progressive hemiparesis and spastic dysarthria over 3 months duration, and MRI showed white matter T2 hyper, T1 isointense and peripherally diffusion restricting lesion in the right frontoparietal region with an additional focal haemorrhage within the lesion, which misled us away from considering PML. However, repeat imaging showed progression of the lesion and CSF analysis showed John Cunningham (JC) virus, confirming the diagnosis.

Published

2024-06-30

Issue

Vol. 29 No. 2 (2024)

Section

Imaging Highlight