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Fig. 3 | Egyptian Journal of Radiology and Nuclear Medicine

Fig. 3

From: Chemotherapy-related neurotoxicity in pediatric cancer patients: magnetic resonance imaging and clinical correlation

Fig. 3

An 8-year-old male diagnosed as lymphoma. The patient received a course of chemotherapy (IV vincristine, IV cyclophosphamide, oral prednisone and intrathecal methotrexate, hydrocortisone, ARA C) after which he developed a disturbed conscious level. Brain MRI was done after 1 day of clinical presentation. MRI revealed: FLAIR images (ad) show bilateral asymmetrical cortical areas of abnormal high signal intensity are seen in frontal (a), parietal (a) and occipital lobes (b) (black arrows). Also, there was bilateral asymmetrical affection of the thalami (c) and involvement of brain stem (d) and basal ganglia (c) (black arrows). DWI (e): The lesions in thalami show high signal (black arrowhead). ADC map (f): The lesions show low signal compared to the contralateral normal brain parenchyma denoting restriction (white arrowhead). There was no appreciable contrast enhancement of the lesions (not shown).The MRI findings are consistent with an atypical MRI pattern of PRES with grade I edema extension of the cerebral lesions and thalami and grade II edema of the brain stem. The patient died after 1 week

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