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. 2025 Oct 4.
doi: 10.1007/s10072-025-08560-6. Online ahead of print.

Entire corpus callosum and diffuse white matter involvement in acute Marchiafava-Bignami disease

Jieqiang Xia #  1 , Qing Lin #  1 , Xue Ke  2
Affiliations

Entire corpus callosum and diffuse white matter involvement in acute Marchiafava-Bignami disease

Jieqiang Xia et al. Neurol Sci. .

Abstract

Acute Marchiafava-Bignami disease (MBD) can extend beyond the corpus callosum to diffuse hemispheric white matter, portending poor outcomes. We report a 57-year-old man with long-standing alcohol abuse who developed weakness and coma. Magnetic resonance imaging (MRI) revealed hyperintense, swollen lesions throughout the corpus callosum and extracallosal white matter on T2-weighted imaging (T2WI)/fluid-attenuated inversion recovery (FLAIR) and diffusion-weighted imaging(DWI), consistent with cytotoxic edema. Despite prompt high-dose thiamine and aggressive supportive care, he died within days. This case underscores the diagnostic value of DWI for early detection and prognostication in acute MBD, and highlights the importance of urgent brain MRI in comatose patients with a background of chronic alcohol abuse.

Keywords: Corpus callosum; Diffusion-weighted imaging; Extracallosal white matter; Marchiafava-Bignami disease; Thiamine.

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Conflict of interest statement

Declarations. Ethical approval: Ethics approval for the study was obtained by the institutional ethics committee of The First People's Hospital of Shuangliu District, Chengdu. Informed consent: Written informed consent was obtained from the patient’s family to publish this case report and any accompanying images. Conflicts of interest: The authors have no conflicts of interest to declare.

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