298

FIGURE 298-1

FIGURE 298-2

FIGURE 298-3

FIGURE 298-4

FINDINGS Figures 298-1 and 298-2. Axial FLAIR through the midbrain and the centrum semiovale. There is widespread sulcal hyperintensity (arrows). Figures 298-3 and 298-4. Axial post-contrast T1WI through the midbrain and the sylvian fissures in the same patient. There is extensive mostly linear subarachnoid space enhancement (arrows) around the midbrain in Figure 298-3 and in the sylvian fissures and convexity sulci in Figure 298-4.

DIFFERENTIAL DIAGNOSIS Leptomeningeal enhancement (LME) due to meningitis, vasculitis, carcinomatosis, lymphoma.

DIAGNOSIS LME due to migraine headache.

DISCUSSION

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