A rare MRI finding in a patient with Marchiafava-Bignami disease

Excerpt

A 64-year-old man with a 40-year history of alcoholism presented with dysarthria and weakness of limbs. Neurological examination revealed decreased consciousness level, weakness (grade 3/5) of upper and lower extremities, and positive Babinski sign of both sides. Brain MRI showed cystic lesions (“Sandwich sign”) and thinning of the corpus callosum and bilateral white matter lesions. High signal intensity along the corticomedullary junction on diffusion-weighted images was observed (Fig. 1). The patient made a clinical improvement after a 2-week treatment with intravenous thiamine, suggesting the diagnosis of Marchiafava-Bignami disease (MBD) [1].

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