A 51-year-old woman presented with aphasia and bifrontal MRI lesions with punctuate and vague linear enhancement (figure). She improved spontaneously but 4 months later deteriorated due to the large mass and required cranial decompression. Innumerable, perivenular enhancements perpendicular to the lateral ventricles were seen within extensive bihemispheric white matter lesions. Multiple scleros...

Whenever MRI imaging depicts typical small, ovoid, well-circumscribed T2 hyperintense lesions scattered across periventricular, iuxtacortical and infratentorial white matter along with a clinical scenario highly suggestive of inflammatory-demyelinating disease of CNS (CNS IID), multiple sclerosis (MS) diagnosis is straightforward. Nevertheless, the expanding role of MRI in MS evaluation is para...