The spectrum of neuroimaging abnormalities in solvent abuse and their clinical correlation

The brain magnetic resonance (MR) images and medical records of 6 patients with a history of chronic toluene abuse were reviewed retrospectively. The imaging findings were correlated with clinical impairment. The major findings consisted of atrophy (6 patients), white matter T2 hyperintensity (6 patients), and T2 hypointensity involving the basal ganglia and thalami (5 patients). Also seen was focal enhancement, previously unreported for patients who abused toluene. This study showed a correlation between the degree of neurological impairment and extent of white matter disease. There was no correlation between the severity of white matter changes on MR images and the presence of T2 hypointensity or duration of toluene abuse. There was no definite clinical evidence of damage to the basal ganglia and thalami despite the MR imaging finding of T2 hypointensity. Temporal evidence against the theory that toluene accumulation causes the T2 hypointensity was found.