Evolution of Callosal and Cortical Lesions on MRI in Marchiafava-Bignami Disease

We report on serial MRI findings of cerebral lesions in a 55-year-old man with severe Marchiafava-Bignami disease (MBD). The first MRI change on fluid-attenuated inversion recovery images was hyperintensity in the genu of the corpus callosum and in the frontoparietal cortex. Following this change, a splenial lesion appeared. The first MRI change in the genu of the corpus callosum was not associated with a change in diffusion on diffusion-weighted MRI imaging, suggesting a pathological change involving vasogenic edema. Development of cortical lesions in the initial stage confirms that cortical lesions result from the primary pathogenetic process induced by alcoholic intoxication and malnutrition in MBD.