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Research ArticleBRAIN

MR Imaging Findings in 56 Patients with Wernicke Encephalopathy: Nonalcoholics May Differ from Alcoholics

G. Zuccoli, D. Santa Cruz, M. Bertolini, A. Rovira, M. Gallucci, C. Carollo and N. Pipitone
American Journal of Neuroradiology January 2009, 30 (1) 171-176; DOI: https://doi.org/10.3174/ajnr.A1280
G. Zuccoli
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D. Santa Cruz
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M. Bertolini
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A. Rovira
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M. Gallucci
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C. Carollo
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N. Pipitone
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    Fig 1.

    A 54-year-old woman with leukemia, changes in consciousness, and ataxia. FLAIR axial images (11,000/140/2 [TR/TE/NEX]). A, The prepositus hypoglossal nuclei show symmetric high-signal-intensity alterations (arrows). B, The medial vestibular nuclei show symmetric hyperintense lesions (arrows). C, Symmetric high-signal-intensity alterations in the facial nuclei (arrows) are detected. Subtle signal-intensity alterations in the abducens nuclei are seen (arrowheads). D, The tectum of the midbrain and the periaqueductal gray matter shows signal-intensity alterations (arrow). E, The mamillary bodies (arrows) show signal-intensity alterations. F, Note signal-intensity alterations (arrows) of the medial thalami and periventricular region of the third ventricle.

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    Fig 2.

    A 54-year-old woman with a history of food refusal had changes in consciousness. FLAIR coronal images (11,000/140/2 [TR/TE/NEX]). A, Signal-intensity alterations with different intensity patterns are seen in the thalami (arrows). Diffuse signal-intensity alterations of the frontal cortex (arrowheads) are present. B, Note signal-intensity alterations in the mamillary bodies (arrows), periventricular region of the third ventricle (empty arrows), and brain cortex (arrowheads).

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    Fig 3.

    A 47-year-old woman with a history of alcohol abuse presented with ataxia, changes in consciousness, and ocular abnormalities. A, FLAIR axial image (9000/114/1 [TR/TE/NEX]). No signal-intensity alteration are seen at the mamillary body level (arrows). B, T1-weighted axial image (551/14/2 [TR/TE/NEX]). Contrast enhancement is seen in the mamillary bodies (arrows).

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    Table 1:

    Topographic distribution of the lesions in AL and NA patients with WE†

    Patient GroupThal (%)Periaq (%)Mam Bodies (%)Tectal Plate (%)CNN (%)Fvgm (%)Cer (%)DN (%)Vermis (%)
    AL6346331304000
    NA94*685252*32*9936
    • Note:—Thal indicates medial thalami and periventricular region of the third ventricle; Periaq, periaqueductal gray matter; Mam bodies, mamillary bodies; Fvgm, periventricular gray matter located anterior to the 4th ventricle; CNN, cranial nerve nuclei; Cer, cerebellum; DN, dentate nuclei.

    • * Indicates positive statistical association.

    • † Imaging sequences included long-TR and short-TE spin-echo sequences and contrast-enhanced short-TR images in multiple planes.

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    Table 2:

    Neurologic symptoms at clinical onset in the AL and NA groups

    GroupCC (%)OA (%)AT (%)T (%)
    AL8392*71*54
    NA94694134
    • Note:—CC indicates changes in consciousness; OA, ocular abnormalities; AT, ataxia; T, classic triad of the disease.

    • * Indicates positive statistical association.

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American Journal of Neuroradiology: 30 (1)
American Journal of Neuroradiology
Vol. 30, Issue 1
January 2009
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MR Imaging Findings in 56 Patients with Wernicke Encephalopathy: Nonalcoholics May Differ from Alcoholics
G. Zuccoli, D. Santa Cruz, M. Bertolini, A. Rovira, M. Gallucci, C. Carollo, N. Pipitone
American Journal of Neuroradiology Jan 2009, 30 (1) 171-176; DOI: 10.3174/ajnr.A1280

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MR Imaging Findings in 56 Patients with Wernicke Encephalopathy: Nonalcoholics May Differ from Alcoholics
G. Zuccoli, D. Santa Cruz, M. Bertolini, A. Rovira, M. Gallucci, C. Carollo, N. Pipitone
American Journal of Neuroradiology Jan 2009, 30 (1) 171-176; DOI: 10.3174/ajnr.A1280
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