Acute Marchiafava‐Bignami Disease with Extensive Diffusion Restriction and Early Recovery: Case Report and Review of the Literature

Abstract

Marchiafava-Bignami disease (MBD) is a neurological disorder that has been found to be associated with chronic alcoholism and malnutrition. MBD classically results in acute edema and demyelination of the corpus callosum. Edema of the complete corpus callosum has been described to be an unfavorable prognostic factor. We present an acute onset of MBD with diffusion restriction of the complete corpus callosum and symmetric bilateral extension into the semioval center, that almost completely resolved clinically as well as in MRI only 3 days later. With early detection and treatment, the prognosis of MBD may be good even in cases with severe diffusion restriction of the complete corpus callosum.

Neuroregression as an initial manifestation in a toddler with acquired pernicious anaemia

“…MRI of the brain findings reported in vitamin B 12 deficiency are ventricular dilation, thinning of the corpus callosum, external hydrocephalus, delayed myelination, myelopathy affecting the anterior, posterior and lateral columns in the cervical and thoracic spinal cord, hyperintensities involving the periventricular white matter, centrum semiovale, internal capsule and middle cerebellar peduncle and Morel laminar sclerosis 7 14 15. MRI of the brain in our patient had shown diffuse cortical atrophy with prominent ventricles and sylvian fissures.…”

Magnetic resonance imaging of leukoencephalopathy in amnestic workers exposed to organotin

“…Acute Marchiafava-Bignami disease (Wenz et al, 2014) in alcoholic patients, the early stages of 5-fluorouracil-induced leukoencephalopathy (Bang et al, 2012) in cancer patients, hypoglycemic encephalopathy (Ma et al, 2009), and reversible posterior leukoencephalopathy syndrome (Xie and Jones, 2016) may have similar patterns of lesions in the corpus callosum and white matter on MRI. However, occupational history and clinical characteristics can differentiate these conditions from leukoencephalopathy due to organotin intoxication.…”

The Importance of Brain MRI in the Diagnosis of Marchiafava-Bignami Disease

“…The clinical presentation is variable, including mental confusion, dementia, psychosis, spasticity and dysarthria [4]. Since the symptoms are not specific, the clinical diagnosis can be difficult, being the magnetic resonance imaging (MRI) of pivotal value in the investigation [5]. Diffuse thickening of the CC andT1 and T2 prolonged areas in the CC are considered characteristic MRI findings at the acute phase.…”

“…However, with the advent of neuroimaging, it was possible to define it through the previous history of alcoholism and pathological changes in the corpus callosum, demonstrated by means of MRI [10]. On the past (1977) Brion et al had introduced a classification for MBD categorizing an acute, a subacute, and a chronic form [5].…”

“…Diffuse thickening of the CC andT1 and T2 prolonged areas in the CC are considered characteristic MRI findings at the acute phase. It has been reported that the first change on MRI is diffuse swelling of the corpus callosum, followed by a genu lesion, and finally by a splenium lesion, sparing the rostrum [5,6]. T1-weighted MRI in the subacute to chronic stage shows hypointense cystic-necrotic lesions in the corpus callosum in addition to callosal atrophy.…”