A 13-year-old boy with ataxia 4 weeks after a near-drowning accident.

Figure 1. A, Magnetic resonance imaging (MRI) of the brain showing hypersignal in the periventricular and left parietal lobe areas in the fluid attenuation inversion recovery (FLAIR) sequence. B, MRI of the cerebellum showing hypersignal in the cerebellar-peduncle areas in the FLAIR sequence. A 13-year-old boy was evaluated at our hospital for fever and ataxia that ensued 4 weeks after a near-drowning accident in a pond of stagnant water. The patient was admitted to another hospital immediately after the accident, where he received mechanical ventilation and advanced life support. This hospitalization was complicated with episodes of ventilator-associated pneumonia that resolved with broad antibiotic coverage. Four weeks after the accident, the patient presented with fever, headache, vomiting, and ataxia and was transferred to our hospital for further evaluation. The physical examination revealed ataxia with right deviation of the gait, and no meningeal signs were detected. Magnetic resonance imaging of the brain showed