Dement Neurocogn Disord.  2014 Mar;13(1):24-26. 10.12779/dnd.2014.13.1.24.

Marchiafava Bignami Disease Potentially Complicating Normal Pressure Hydrocephalus

• Lee S
• Yoo I
• Lee KH
• Yang HD

• KMID: 1973687
• DOI: http://doi.org/10.12779/dnd.2014.13.1.24

Abstract

Marchiafava-Bignami disease (MBD) is a rare disorder of demyelination or necrosis of the corpus callosum. Mainly, MBD is associated with alcohol and malnutrition. We report a 60-year-old woman with no history of alcohol consumption or malnutrition who had MBD as a possible complication of normal pressure hydrocephalus (NPH). The patient presented with a 2-month history of progressive gait unsteadiness, urinary incontinence, and forgetfulness, for which the patient underwent ventriculoperitoneal shunt surgery with remarkable improvement. Magnetic resonance imaging (MRI) demonstrated hyperintensity in the body and splenium of corpus callosum when she was brought to the hospital again with rapid deterioration of her mental ststus. It might be postulated that cerebrospinal fluid (CSF) tumor necrosis factor-alpha (TNF-alpha) might have contributed to the development of MBD although not measured in this patient, given that TNF-alpha, as a proinflammatory cytokine mediating demyelinating process have been found in be increased in the CSF of NPH.

Keyword

Marchiafava-Bignami disease; Normal pressure hydrocephalus; Complication

MeSH Terms

Alcohol Drinking
Cerebrospinal Fluid
Corpus Callosum
Demyelinating Diseases
Female
Gait
Humans
Hydrocephalus, Normal Pressure*
Magnetic Resonance Imaging
Malnutrition
Marchiafava-Bignami Disease*
Middle Aged
Necrosis
Negotiating
Tumor Necrosis Factor-alpha
Urinary Incontinence
Ventriculoperitoneal Shunt
Tumor Necrosis Factor-alpha

Figure

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  Fig. 1 The findings on the MRI and CT of the brain. The initial axial and saggital MR images reveal the enlarged ventricles (A-C). Brain CT images 2 months after the readmission show the hypointense lesions in the corpus callosum (D-F) and axial fluid-attenuated inversion recovery (FLAIR) MR images demenstrate the lesions with hyperintensity in the corpus callosum (G-I).

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