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Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
Diffusion weighted imaging in heroin-associated spongiform leukoencephalopathy
Danny S Bega1, Laura M McDaniel, Miral D Jhaveri
1Department of Neurological Sciences, Rush University Medical Center, 1725W. Harrison St #1121, Chicago, IL 60612, USA.
Neurocritical Care
|January 1, 2009
Summary
Heroin-associated spongiform leukoencephalopathy (HASL) is rare. Diffusion-weighted imaging (DWI) detects acute HASL earlier than FLAIR MRI, showing restricted diffusion in the globus pallidus and cerebral cortex.
Area of Science:
- Neurology
- Radiology
- Toxicology
Background:
- Heroin-associated spongiform leukoencephalopathy (HASL) is a rare neurological complication linked to heroin abuse.
- Early detection of HASL is crucial for patient management and understanding disease progression.
Observation:
- A case report details a 36-year-old male with a history of heroin snorting presenting with lethargy.
- Initial MRI revealed restricted diffusion in the globus pallidus and cerebral cortex, not visible on FLAIR sequences.
Findings:
- Diffusion-weighted imaging (DWI) demonstrated acute changes consistent with HASL.
- Follow-up MRI at 3 months showed subcortical white matter atrophy and T2 hyperintensity, confirming leukoencephalopathy.
- Neurological examination at 3 months was nonfocal, suggesting potential for recovery.
Implications:
- DWI is more sensitive than FLAIR MRI for detecting acute HASL.
- Restricted diffusion on DWI may represent early myelin edema, correlating with electron microscopic findings.
- Awareness of DWI findings is essential for clinicians diagnosing and managing HASL.
