Legend Diffuse bilateral T2/FLAIR hyperintensity is seen throughout the subcortical white matter and the entire corpus callosum. Bilateral cerebral peduncles are also involved.

Legend There is restricted diffusion in bilateral cerebral peduncles, globus pallidi and posterior limbs of the internal capsules with corresponding dark ADC map. Cystic areas of bright DWI signal are seen in the splenium of the corpus callosum and left periatrial white matter without dark ADC map, likely representing T2 shine through.

Legend MR spectroscopy demonstrates elevated choline and decreased NAA/Cr. Gradient-echo images reveal multiple focal hemorrhages in the subcortical white matter and corpus callosum. Key words: mri mrs metabolic

Brain Diagnosis: Marchiafava Bignami disease