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Acute Marchiafava-Bignami Disease: MR Findings in Two Patients

Andres Arbelaeza, Adriana Pajona and Mauricio Castillob

a Department of Radiology, Instituto Neurologico de Antioquia, Medellin, Colombia
b Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, NC



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  		FIG 1. Case 1, a 56-year-old man who presented with vertigo and unstable gait of 2 days’ duration.

A, Parasagittal MR T1-weighted image shows multiple areas of decreased signal intensity involving the genu and the anterior aspect of the corpus callosum.

B, MR T2-weighted image corresponding to A shows the lesions to be hyperintense and also some mild atrophy of the involved portions of the corpus callosum.

C, MR Axial T2-weighted image shows a mild degree of periventricular white matter hyperintensity, particularly in the region of the frontal horns of the lateral ventricle.

D, Axial T2-weighted image at the level of the centra semiovale shows a mild degree of periventricular white matter hyperintensities.



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  		FIG 2. Case 1, follow-up MR images obtained 3 months after the initial study.

A, Parasagittal T2-weighted image shows persistent hypertensity in the genu and anterior body of the corpus callosum.

B, Coronal T2-weighted image from the follow-up study shows atrophy and increased signal intensity in the corpus callosum and no periventricular white matter abnormalities. There is prominence of CSF-containing spaces secondary to diffuse atrophy.



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  		FIG 3. Case 2, a 65-year-old man, known to be a chronic alcoholic and to have hepatic cirrhosis, who presented with an acute onset of altered mental status, seizures, and Parkinson-like movements.

A, Midsagittal MR T2-weighted image shows increased signal intensity in the posterior body of the corpus callosum without any mass effect. There is atrophy of the cerebellar vermis particularly its superior aspects.

B, Axial MR FLAIR image shows increased signal intensity in the frontal white matter and in the periventricular areas.





Copyright © 2008 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X