Figure 2

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 4^th 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.