Recent US Case of Variant Creutzfeldt-Jakob Disease—Global Implications
Atul Maheshwari
, Michael Fischer, Pierluigi Gambetti, Alicia Parker, Aarthi Ram, Claudio Soto, Luis Concha-Marambio, Yvonne Cohen, Ermias D. Belay, Ryan A. Maddox, Simon Mead, Clay Goodman, Joseph S. Kass, Lawrence B. Schonberger, and Haitham M. Hussein
Author affiliations: Baylor College of Medicine, Houston, Texas, USA (A. Maheshwari, A. Parker, A. Ram, C. Goodman, J.S. Kass); Harris Health System, Houston (A. Maheshwari, A. Parker, A. Ram, J.S. Kass); Texas Department of State Health Services, Austin, Texas, USA (M. Fischer); Case Western Reserve University School of Medicine, Cleveland, Ohio, USA (P. Gambetti, Y. Cohen); University of Texas Medical School at Houston, Houston (C. Soto, L. Concha-Marambio); Universidad de los Andes, Santiago, Chile (L. Concha-Marambio); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (E.D. Belay, R.A. Maddox, L.B. Schonberger); University College London Institute of Neurology, London, UK (S. Mead); HealthPartners Clinics & Services, St. Paul, Minnesota, USA (H.M. Hussein)
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Figure 2
Figure 2. Magnetic resonance imaging (MRI) results for a US patient with variant Creutzfeldt-Jakob disease. T1 sequence (A) and T2 FLAIR sequence (B) show the “pulvinar” or “hockey stick” sign (arrowhead). Initial diffusion weighted imaging (DWI) (C) and apparent diffusion coefficient (ADC) (D) images show subtle restricted diffusion in the right primary motor cortex (arrows). Subsequent MRIs show increasing hyperintensity (arrows) on DWI (E, then G) and further attenuation (arrows) on ADC (F, then H), consistent with the “cortical ribbon” sign.
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