Typical magnetic resonance imaging (MRI) patterns in cerebral Alexander disease (neonatal/infantile, type I)

In the cerebral (neonatal/infantile or type I) form of Alexander disease, the white matter is extensively involved, typically showing a frontal predominance (A) or, in some cases, extending to the occipital lobes (B) and involving all (or nearly all) of the white matter. Deep gray abnormalities (C) and a periventricular rim (D) are present. The most frequent brainstem finding is symmetric T2 hyperintensities of the medulla (E). Contrast is variable and is perhaps more abundant in the neonatal form (F) compared with the infantile form (G), but it is not universally present.