Computed tomography (CT) in a child with typical clinical and biochemical features of adrenoleukodystrophy (ALD) revealed striking pathologic enhancement in the centra semiovalia, posterior corpus callosum and corticospinal tracts within the internal capsules, cerebral peduncles and basis pontis. Central calcifications were detected within otherwise typical symmetrical low attenulation lesions in the periatrial white matter. The findings expand the spectrum of CT abnomalities in ALD and may represent a link between the recently described Tye I and Type II CT patterns.