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©2013 UpToDate ® Print Email Late brain MRI of a patient with presumed juvenile Alexander disease, obtained at the age of 10 years There is extensive white matter involvement with frontal preponderance (A). The basal ganglia are dark and atrophic on T2-weighted images (A). A thin periventricular rim of low signal intensity is just visible (arrows, A). After contrast administration, enhancement of the entire cerebellar surface and dentate nucleus is seen (B). Reproduced with permission from: van der Knaap, MS, Naidu, S, Breiter, SN, et al. Alexander disease: diagnosis with MR imaging. AJNR Am J Neuroradiol 2001; 22:541. Copyright ©2001 American Society of Neuroradiology.