FINDINGS Figure 214-1. Axial T2WI through the trigones. There is bilateral symmetrical peritrigonal confluent white matter (WM) hyperintensity extending from the ventricular walls to the subcortical U fibers (stars) crossing the midline through the splenium of corpus callosum. Figure 214-2. Coronal post-contrast T1WI through the trigones. There is bilateral symmetrical centrally affected WM hypointense with peripheral wavy contrast enhancement following the pattern of the subcortical U fibers (arrows).
DIFFERENTIAL DIAGNOSIS Krabbe disease, metachromatic leukodystrophy (MLD), Alexander disease, Adrenoleukodystrophy (ALD), Canavan disease.
DIAGNOSIS Adrenoleukodystrophy (ALD).
DISCUSSION
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