Head MRI of a 65-year-old patient with biopsy-proven sporadic CJD (Heidenhain variant).
(Image A) A T2 MRI that shows essentially normal signal intensity within the basal ganglia and throughout the brain.
(Image B) A proton density MRI that shows increased cortical signal intensity within the right frontal lobe and bilateral medial occipital lobes.
(Image C) A diffusion-weighted MRI (DWI) that reveals more conspicuous involvement of the right frontal lobe and more extensive hyperintensities of the bilateral occipital lobes with no involvement of the basal ganglia.
(Image D) A DWI rostral to the basal ganglia that shows extensive cortical involvement throughout the brain with more prominence posteriorly, as may be expected with the Heidenhain variant.