Marchiafava-Bignami Disease in a Postoperative Non-alcoholic Patient

Abstract

Marchiafava-Bignami disease (MBD) is a neuropathological condition characterized by demyelination and necrosis of the corpus callosum. This condition is commonly found in malnourished and alcoholic patients, but it is rarely observed in non-alcoholic individuals. In this case report, we describe a non-alcoholic patient who underwent two consecutive gastrointestinal surgeries. After the surgeries, he developed seizures and was diagnosed with MBD based on a plain head MRI. However, with the proper treatment, his condition stabilized, and he was discharged. This case serves as a beacon of hope, demonstrating that MBD, even in non-alcoholic patients, can be reversible with appropriate imaging and treatment.

Keywords: marchiafava-bignami disease; mri; non-alcoholic; s:malnutrition; splenium of the corpus callosum; thiamine or vitamin b1 deficiency.

Figure 1. (A) T2W MRI and (B) FLAIR MRI

(A) T2W image shows hyperintensity involving the splenium of the corpus callosum. (B) FLAIR image shows subtle hyperintensity involving the splenium of the corpus callosum. FLAIR: fluid-attenuated inversion recovery

Figure 2. (A) DWI MRI and (B) ADC MRI

(A) DWI shows oval hyperintensity throughout the splenium and into the adjacent hemisphere ("boomerang sign"). (B) Corresponding ADC map shows hypointensity due to restricted diffusion involving the splenium of the corpus callosum. DWI: diffusion-weighted imaging; ADC: apparent diffusion coefficient