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Progressive meningeal disease in acute lymphoblastic leukemia (MRI) (2)

Seven days after the initial MRIs were performed, the patient underwent a repeat brain MRI because of a progressive decline in mental status and possible cortical blindness. There is no evidence of enhancement on these pre- and postcontrast T1-weighted images, though there is evidence of increased hypointense signal surrounding the sulci. On FLAIR, there is increased signal in the right and left occipital lobes and left temporal lobe. This correlates with an area restricted to diffusion on diffusion-weighted images. (Contributed by Dr. Jon Glass.)

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