The significance of the peritrigonal hyperintensities on T2W sequences in elderly patients was studied, by Kitajima et al. using MRI of 160 patients , their clinical presentation, and gross pathology specimens in patients who had died of non neurologic causes, but had hyperintensity in the same regions. The study concluded that the hyperintensities are due to myelin pallor, infarcts or ischaemic changes, perivascular spaces, and that these changes do not cause any visual deficits or other clinical symptoms.

Seen in M.S.
Hyperintensity in the
tapetum bilaterally

Seen in elderly patients
Hyperintensity in the tapetum
and optic radiations bilaterally

Answer to question
The Tapetum really does exist. Its signal is different from that of the adjacent optic radiations. It is often a site of plaques of Multiple Sclerosis, in addition to those in the radiations of the corpus callosum and the forceps.

This is a part of my tribute to a great teacher, who reminds us not to forget the basics.

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Volume 16 _ number 3_ Bibliothèque nationale, ISSN 1180-0844 National Library of Canada,
Production _ Denis Melançon _ Neurikon Inc; Assistant production: Sunithi Mani
Layout, Web and Graphic Design by the Department of Neurophotography at the Montreal Neurological Hospital (10-1999)