The focal and diffuse cerebral white matter injury can be caused by treatment with radiation therapy for cranial tumors. However, the literature rarely describes a MRI finding in radiation-induced delayed extensive cerebral injury. Our objective was to report a rare case who had a delayed extensive hyperintensity injury in brain on MRI after radiation therapy due to nasopharyngeal cancer. A MRI was performed on a 40-year-old patient with extensive brain damage who had the radiation therapy two years ago.MRI finding was evaluated. On MRI, T2-weighted MRI showed an extensive hyperintensity after treated by irradiation. The radiographic pattern of extensive cerebral injury is relatively distinct. It involves the white matter and gray matter in cerebral, cerebellum, medulla oblongata, pons, internal capsule and thalamus bilaterally. Our observations demonstrate that the extensive hyperintensity lesions in brain on MRI after radiation therapy is a cortical laminar necrosis and white matter myelinolysis.
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