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Acute Marchiafava-Bignami disease with selective involvement of the precentral cortex and splenium: a serial magnetic resonance imaging study.
- Source :
-
The neurologist [Neurologist] 2011 Jul; Vol. 17 (4), pp. 213-7. - Publication Year :
- 2011
-
Abstract
- Introduction: Marchiafava-Bignami disease (MBD) is defined pathologically as callosal degeneration associated with chronic alcoholism. We report a patient with MBD with acute lesions confined in the precentral cortex and splenium. Various magnetic resonance imaging (MRI) modalities were performed sequentially to elucidate the pathophysiology.<br />Case Report: A 52-year-old man with chronic alcoholism developed acute confusion and dysarthria. He improved incompletely with nutritional supplementation. Diffusion-weighted imaging MRI disclosed the presence of reversible lesions with low apparent diffusion coefficient values in the precentral cortex and splenium. Perfusion-weighted imaging revealed that the cerebral blood volume and flow decreased and subsequently increased, and the mean transit time and time to peak were persistently prolonged. On magnetic resonance spectroscopy, choline was initially normal and became elevated during the recovery period, whereas N-acetylaspartate was low initially and after the resolution of the lesion on conventional MRI.<br />Conclusions: The precentral cortex and splenium are the most vulnerable areas in acute MBD. The lesions have reversible restricted diffusivity and hypoperfusion. The magnetic resonance spectroscopy findings correlate well with the clinical status.
- Subjects :
- Alcoholism complications
Alcoholism pathology
Cerebrovascular Circulation physiology
Humans
Magnetic Resonance Imaging methods
Magnetic Resonance Spectroscopy methods
Male
Marchiafava-Bignami Disease etiology
Middle Aged
Cerebral Cortex pathology
Corpus Callosum pathology
Marchiafava-Bignami Disease pathology
Subjects
Details
- Language :
- English
- ISSN :
- 2331-2637
- Volume :
- 17
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- The neurologist
- Publication Type :
- Academic Journal
- Accession number :
- 21712668
- Full Text :
- https://doi.org/10.1097/NRL.0b013e31821a25ae