The evolution of white matter disease as seen on computed tomography

The evolving computed tomographic (CT) findings in three patients with different types of dysmyelinating white matter diseases (Krabbe, Canavan, ketotic hyperglycinemia) are presented. Serial CT scans suggested that the abnormal, low density white matter, which is characteristic of many white matter diseases, is present for only a limited time, corresponding to active dys- or demyelination. The low density abnormality gives way to a nonspecific final common pathway manifested as severe atrophy on CT. Ventricular enlargement is accentuated in this form of atrophy which appears to be the final stage in a wide variety, if not all, of white matter diseases.