A Case of Acute Disseminated Encephalomyelitis in a Middle-Aged Adult

Figure 1

(a) Axial (T2/FLAIR) MRI showing supratentorial white matter (WM) hyperintensities extending from the periventricular region to the subcortical fibers. (b) Sagittal (T2/FLAIR) MRI showing diffuse periventricular WM intensities. (c) Axial (T2/FLAIR) MRI showing interval improvement and resolution of the periventricular WM lesions. (d) Sagittal (T2/FLAIR) MRI demonstrating the improvement of the periventricular WM lesions. (e) H&E stain shows areas of pallor containing macrophage that represent areas of demyelination (original magnification 200x). (f) Clusters of macrophages in the areas of demyelination are highlighted by immunohistochemical staining for macrophage marker CD68 (original magnification 200x). (g) Relative preservation of axons that are seen to traverse the macrophage rich areas of demyelination is demonstrated on neurofilament immunohistochemical stain (original magnification 400x). (h) Multiple pink areas of myelin loss are present in the background of normal appearing blue staining cerebral white matter on Luxol Fast Blue/PAS stain (original magnification 100x).