Case 078

History/Physical

History/Physical:

62-year-old right-handed female.

One month history of fluctuating mild right-sided weakness.

There are confluent and discrete lesions. There is subcortical white matter involvement (arrows) and periventricular disease (arrowheads).

There is posterior fossa disease involving left cerebellar peduncle (arrow).

Diagnosis: Acute demyelination, consistent with acute disseminated encephalomyelitis

Perivascular lymphocytic cuffing (arrow) and areas of macrophage infiltration (*).

Higher magnification of reactive astrocytes (*) and macrophages (arrow).

Myelin degradation products (blue) within macrophages (arrow).