Brain T2-weighted MRI representative of severe LTBL. Axial T2- (a–c and e–g) and T1-weighted images (d and h) in (EARS2) patient 9 at 8 months (a–d) and 4 years (e–h). Note the diffuse T2-hyperintense and T1-hypointense signal of the cerebral white matter, only sparing a periventricular rim (a, b, and d). There are also signal abnormalities in the thalami (b) and the midbrain (c). Three years later, there is a serious atrophy of the cerebral white matter and thalami (d, e, and h). The midbrain signal abnormalities have disappeared (f). Reprinted with permission .