Hemiparesis with multiple periventricular enhancing lesions on cranial CT

Area of Science:

• Neuroscience
• Radiology
• Neurology

Background:

• Acute demyelinating processes can present with focal neurological deficits.
• Cerebral imaging is crucial for diagnosing and monitoring demyelinating conditions.

Observation:

• A 23-year-old woman presented with acute right hemiparesis and subsequent spontaneous remission.
• Computed tomography (CT) demonstrated multifocal, contrast-enhancing periventricular cerebral lesions.

Findings:

• Serial CT examinations showed complete resolution of the initial abnormalities.
• Right internal carotid angiography revealed prominent deep medullary veins with fleck-like stains.

Implications:

• The observed angiographic features suggest potential vascular involvement in the acute demyelinating process.
• This case highlights the dynamic nature of demyelinating lesions and associated vascular changes.