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Click 42 year-old male who presented with vague right sided stroke-like symptoms and was found to have nonketotic hyperglycemia. Axial non-contrast computed tomography of the head performed at ten months prior to current presentation (Protocol: Philips 64-slice CT scanner, 501mAs, 120 kvp, 5mm slice thickness). Unremarkable examination, particularly no hyperdensity is present within the basal ganglia or caudate nuclei.

Click 42 year-old male who presented with vague right sided stroke-like symptoms and was found to have nonketotic hyperglycemia. Axial non-contrast computed tomography of the head performed at time of current presentation (Protocol: Philips 64-slice CT scanner, 350mAs, 120 kvp, 5mm slice thickness). Interval development of hyperdensity within the caudate nuclei and left lentiform nucleus which respects the neuroanatomic boundaries of the basal ganglia without associated edema.

Click 42 year-old male who presented with vague right sided stroke-like symptoms and was found to have nonketotic hyperglycemia. Axial susceptibility weighted MR images of the brain performed at time of current presentation. (Protocol: 1.5T Philips Intera MR scanner, susceptibility-weighted imaging (VEN_BOLD_HR SENSE) sequence, TR=23.60, TE=33.60, no contrast). Susceptibility weighted images are unremarkable without basal ganglia or caudate nuclei blooming to suggest blood products.

Click 42 year-old male who presented with vague right sided stroke-like symptoms and was found to have nonketotic hyperglycemia. Axial diffusion-weighted MR images performed at time of current presentation. (Protocol: 1.5T Philips Intera MR scanner, diffusion-weighted imaging (DWI), TR=3873.32, TE=73.10, no contrast). Diffusion weighted imaging demonstrates faint restricted diffusion in the left putamen. No additional foci of restricted diffusion are identified.

Click 42 year-old male who presented with vague right sided stroke-like symptoms and was found to have nonketotic hyperglycemia. Axial ADC map MR images of the brain performed at time of current presentation. (Protocol: 1.5T Philips Intera MR scanner, diffusion-weighted ADC map, TR=3873.32, TE=73.10, no contrast). ADC map demonstrates faint restricted diffusion in the left putamen. No additional foci of restricted diffusion are identified.

Click 42 year-old male who presented with vague right sided stroke-like symptoms and was found to have nonketotic hyperglycemia. Axial pre-contrast T1-weighted MR images of the brain performed at time of current presentation. (Protocol: 1.5T Philips Intera MR scanner, T1-weighted imaging, TR=586.65, TE=12, pre-contrast). Pre-contrast imaging demonstrates intrinsic T1 shortening of the left globus pallidus corresponding to the hyperintensity seen on presenting CT.

Click 42 year-old male who presented with vague right sided stroke-like symptoms and was found to have nonketotic hyperglycemia. Axial post-contrast T1-weighted MR images of the brain performed at time of current presentation. (Protocol: 1.5T Philips Intera MR scanner, fat saturated T1-weighted imaging, TR=595.10, TE=12, with 18ml of gadodiamide (Omniscan, GE health care, Princeton, NJ) injection). Post-contrast imaging demonstrates contrast enhancement in the lentiform and caudate nuclei (left much greater than right).

Click 42 year-old male who presented with vague right sided stroke-like symptoms and was found to have nonketotic hyperglycemia. Axial fluid attenuated inversion recovery MR images of the brain performed at time of current presentation. (Protocol: 1.5T Philips Intera MR scanner, fluid attenuated inversion recovery imaging (FLAIR), TR=11000, TE=140, no contrast). FLAIR imaging demonstrates subtle hyperintense signal abnormalities in the globus pallidus (left greater than right) and left putamen. Flair hyperintensity, compatible with Wallerian degeneration from the patientís known prior stroke, extends from the right midbrain caudally through the right anterior medulla in the expected location of the corticospinal and corticobulbar tracts.

Click 42 year-old male who presented with vague right sided stroke-like symptoms and was found to have nonketotic hyperglycemia. Sagittal pre-contrast T1-weighted MR images of the brain performed at time of current presentation. (Protocol: 1.5T Philips Intera MR scanner, T1-weighted imaging, TR=541.53, TE=12, pre-contrast). Pre-contrast imaging demonstrates intrinsic T1 shortening of the left globus pallidus.

Click 42 year-old male who presented with vague right sided stroke-like symptoms and was found to have nonketotic hyperglycemia. Sagittal post-contrast T1-weighted MR images of the brain performed at time of current presentation. (Protocol: 1.5T Philips Intera MR scanner, T1-weighted imaging, TR=541.53, TE=12, with 18ml of gadodiamide (Omniscan, GE health care, Princeton, NJ) injection). Post-contrast imaging demonstrates contrast enhancement in the lentiform and caudate nuclei (left much greater than right).