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Neurol Sci (2010) 31:213215 DOI 10.1007/s10072-009-0205-9
CASE REPORT
Reversibility of brain lesions in a case of Neuro-Behets disease studied by MR diffusion
Luisa Vuolo Laura Bonzano Caterina Roccatagliata
Roberto Carlo Parodi Luca Roccatagliata
Received: 7 October 2008 / Accepted: 14 December 2009 / Published online: 30 January 2010 Springer-Verlag 2010
Abstract Behets disease is a multisystem disorder rst described in 1937 as a triad of oral and genital ulcerations and uveitis. The etiology is unknown. Involvement of the central nervous system (CNS) occurs in 1025% of patients [1]. Neuro-Behets disease (NBD) can be classied as: (1) parenchymal, with a predilection for brainstem, basal ganglia and thalami involvement, subcortical white matter damage, spinal cord lesions, and meningoencephalitic presentations; (2) vascular, which usually affects major intracranial vessels with frequent involvement of the venous sinuses, cerebral veins and rarely intracranial arteries [2]. Even if not constantly demonstrated in the CNS [3] a vasculitic process involving small blood vessels, including venules, is regarded as an important pathological feature [1, 2]. We describe the case of a patient with NBD studied with conventional and diffusion weighted MR imaging.
Keywords Neuro-Behets disease Vasculitis
MRI Diffusion weighted imaging Apparent diffusion
coefcient
Case report
A 30-year-old man was admitted for mental status changes to the Emergency Department of our Institution. The patient was diagnosed with Behets disease at the age of 25, according to the International Study Group criteria for the diagnosis [4] and was free from medications. At neurological examination, patient was stuporous, physical examination revealed aphthous ulcers in the oral mucosa and genital ulcers.
MR imaging was performed with a 1.5 T system (Signa Excite, GE Medical Systems) at admission and 2 weeks later. MR examination included: T2-weighted images (TR/ TE 9,002/92.416 ms; eld of view 240 mm; matrix 256 9 256), uid-attenuated inversion-recovery images (FLAIR) (TR/TE 9,002/97.13 ms; inversion time 2,250 ms; eld of view 240 mm; matrix 256 9 256), 2D TOF MR venography (TR/TE 30/5.8 ms; eld of view 220 mm; matrix 256 9 256), diffusion weighted images (DWI) (b = 1,000 s/mm2, TR/TE 8,000/82.5 ms; eld of view 260 mm; matrix 256 9 256), T1-weighted images obtained before and...