Spine MRI in a patient with chronic meningitis due to brucellosis

32-year-old female with 5 months of progressive imbalance, gait disorder, blurry vision, bilateral CN VI palsies, and hydrocephalus. Post-contrast T1-weighted sagittal (A) and axial (B-F) spine MRI shows extensive, abnormal linear and nodular leptomeningeal enhancement coating the entire spinal cord and nerve roots of the cauda equina. Lumbar CSF showed 58 nucleated cells per microL (mononuclear predominance), elevated protein (>600 mg/dL), and normal glucose. Serum Brucella IgM was 1.44 (elevated) and IgG was 0.21 (low).