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Figure 5b. Sporadic Creutzfeldt-Jakob disease in a 67-year-old woman 9 weeks after the onset of progressive dementia and visual hallucinations and 9 weeks before the appearance of periodic synchronous discharges on the EEG and a negative result for 14-3-3 protein testing in the cerebrospinal fluid. (a) Axial T2-weighted MR image shows an area of subtle abnormal signal hyperintensity in the right temporo-occipital cortex. (b–d) Axial diffusion-weighted images show bilateral areas of abnormal high signal intensity at three different levels in the cerebral cortex. (e) Axial ADC map from diffusion-weighted imaging shows the lesions as areas of decreased signal intensity. (f) Coronal FLAIR image shows areas of abnormal high signal intensity in the cerebral cortex that correspond to but are less obvious than those observed on the diffusion-weighted images. (g) MR spectroscopic image reveals a decrease of N-acetylaspartate in the head of the right caudate nucleus. (h) Statistical parametric maps of brain perfusion, obtained with 99mTc-ECD SPECT 2 days before MR imaging, reveal areas of perfusion deficit that correspond to the areas of abnormal high signal intensity on diffusion-weighted images. However, these findings are nonspecific for Creutzfeldt-Jakob disease.
