MRI showed frontal predominant white matter involvement associated with scattered areas of restricted diffusion on diffusion weighted imaging (DWI) and areas of intraparenchymal calcification on CT brain, features most consistent with adult-onset leukoencephalopathy with axonal spheroids (ALSP)/CSF1R-related leukoencephalopathy (Figures 2A–D). This evidence concerns the gene CSF1R and Leukoencephalopathy.