Adrenoleukodystrophy: characteristic appearance of CT and brain scan

I recently observed two patients with adrenoleukodystrophy who had similar, distinctive CT scans of the head. The first patient also had a characteristic nuclear brain scan; the second patient was initially thought to have subacute sclerosing panencephalitis until the CT scan was obtained. Classification of leukodystrophies has been controversial and ambiguous. CT and nuclear brain scanning promise to be helpful in nosology of these disorders, as well as the clinical management of the patients.