Marchiafava-Bignami disease with widespread lesions and complete recovery

Abstract

MBD is a rare disorder strongly associated with alcoholism. It is characterized pathologically by demyelination and necrosis of the corpus callosum. MBD presents with severe neurologic deficits and significant sequelae developing in most survivors. We report a patient with total clinical recovery. Serial MR imaging demonstrated typical lesions with restricted diffusion in the acute stage and total resolution without atrophy or cystic change.

Fig 1.

MR images obtained on day 5. A–D, On axial T2WI, the lesions appear hyperintense in the middle cerebellar peduncles, cerebral peduncles, internal capsules, and hemispheric white matter. E–H, On corresponding DWI, the lesions appear hyperintense. I, On sagittal T2WI, hyperintense lesions are seen throughout the corpus callosum.

Fig 2.

Follow-up MR images obtained on days 17 (A–C) and 30 (D–F). A, On axial T2WI, hyperintense lesions are seen in the splenium and internal capsules. B and C, On axial DWI and an ADC map, the lesions appear hyperintense in DWI and hypointense on the ADC map in the splenium and internal capsule. D–F, On follow-up MR images obtained 3 months after onset, note the disappearance of all signal-intensity abnormalities on axial T2WI, DWI, and sagittal T2WI.