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- Chemotherapy
- Uni or bilateral periventricular WM restricted diffusion without FLAIR abnormality
- Acute (< 1 mos)
- Resolves in 2-3 weeks, FLAIR abnormality appears later
- Butterfly appearance of corpus callosum
- Focal cerebral necrosis from intraventricular chemotherapy
- Diff Dx: GBM, lymphoma
- Diffuse WM FLAIR hyperintensity (days-weeks after treatment)
- Induced reversible leukoencephalopathy
- Cortical and subcortical WM FLAIR hyperintensity
- PRES (can also involve basal ganglia)
- Myelopathy in the spinal cord
- Immunotherapy
- WM + CC FLAIR hyperintensity, no enhancement
- DiffDx: HIV encephalopathy
- Enlargement and enhancement of pituitary stock and gland
- Ipilimumab (melanoma treatment) induced hypophysitis
- Returns to normal in 4-6 weeks after steroids
- EOM enlargement and enhancement
- Ipilimumab induced ocular myositis
- Radiotherapy
- Progressive symmetrical confluent WM FLAIR hyperintensities
- Scattered microbleeds
- Radiation induced cavernoma
- Vasculopathy
- Gyri form enhancement posteriorly
- Stroke-Like Migraine Attacks after RT (SMART)
- 6-30 yrs after RT
- “Spreading wavefront” or heterogenous lesion enhancement with low CBV on MR perfusion, elevated lipid-lactate peak, decreased metabolites
- Radiation induced necrosis
- Mineralizing microangiopathy
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