Adrenoleukodystrophy: early frontal lobe involvement on computed tomography

The computed tomographic (CT) findings in a teenage boy with adrenoleukodystrophy (ALD) are presented. Clinical presentation included the subacute onset of dementia and behavioral changes. Bilateral, isolated, symmetric low density areas were present in the frontal lobes on CT, without contrast enhancement. Minimal calcification was noted in the lesions. This unusual pattern of early frontal lobe demyelination in ALD is discussed.