MRI of paediatric patient with fatal CM from Malaŵi presenting severe brain swelling. Admission axial T2 scan (TR 3140, TE 123) of a 4 years old male child with fatal retinopathy-positive CM performed at Queen Elizabeth Central Hospital in Blantyre, Malaŵi (A). Severe brain swelling is observed, with complete loss of sulcal markings. (B) shows a lower slice depicting severe brainstem compression resulting from the swelling. A mid-sagittal T1 Flair image (TR 2311, TE 26, ET 2) of the same patient reveals the complete effacement of all basilar cisterns and the 4th ventricle, as well as severe brainstem compression (C). Finally, (D) shows potential diffuse restricted diffusion in the cerebral cortex and white matter. The child succumbed from respiratory failure 3 hours after these images were obtained.