A 65-year-old woman with diabetes and chronic renal disease was brought in an altered state of sensorium with seizures. Blood reports revealed raised blood urea-nitrogen and creatinine levels.
MRI of the brain shows symmetric T2/FLAIR hyperintensities involving the basal ganglia, predominantly, the putamen. The white matter surrounding the basal ganglia- the internal and external capsules and the medullary laminae are hyperintense, giving the appearance of a fork – the ‘Lentiform fork’ sign. Non-contrast enhanced CT scan of the brain shows confluent hypodensities involving the basal ganglia and thalami.