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Cascade Sign: Expanding The Spectrum.

Rajarshi Chakraborty1, Ankit Khetan, Rajesh Verma

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|November 11, 2025
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Summary
This summary is machine-generated.

The cascade sign, a brain imaging finding, is not exclusive to neuro-Behcet's disease (NBD). This study reveals its presence in other neurological conditions, broadening diagnostic considerations.

Keywords:
Cascadedemyelinating disorderneuro-Behcetoutcome

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Area of Science:

  • Neurology
  • Radiology
  • Neuroimaging

Background:

  • The cascade sign is characterized by mesodiencephalic coronal hyperintense signals on brain imaging.
  • It has been classically associated with neuro-Behcet's disease (NBD).

Purpose of the Study:

  • To investigate the occurrence and significance of the cascade sign beyond its typical association with NBD.
  • To determine the etiologies and outcomes associated with the cascade sign in a broader patient cohort.

Main Methods:

  • A case series approach was employed, including consecutive patients presenting with the cascade sign on brain imaging.
  • Etiological investigations and outcome assessments were conducted for all included cases.

Main Results:

  • The cascade sign was identified in conditions beyond NBD, including demyelinating disorders such as multiple sclerosis, myelin oligodendrocyte glycoprotein antibody-associated disease, and clinically isolated syndrome, as well as glioma.
  • Clinical presentations associated with the cascade sign were diverse, encompassing focal neurological deficits, tremors, ataxia, seizures, dysphagia, dysarthria, and behavioral abnormalities.

Conclusions:

  • The cascade sign represents a neuroimaging phenomenon that extends beyond neuro-Behcet's disease.
  • Recognition of the cascade sign in various neurological disorders is crucial for accurate diagnosis and management.