Objective.
@EN To correlate the MRI findings in acute and chronic stage of Wernicke encephalopathy with the well-known clinical and pathologic findings.
@ES Background.
@EN Wernicke encephalopathy is an acute phase of Wernicke-Korsakoff syndrome. Pathologic findings change betwen acute and chronic phases. Only a few MRI studies have been done in this disease to date.
@ES Methods.
@EN Ten consecutive patients with Wernicke encephalopathy were evaluated with MRI; seven within 24 hours of thiamine treatment, and three between 2 and 4 days They presented with confusion, ophthalmoplegia and gait ataxia which improved with
intravenous
thiamine. Korsakoff psychosis became evident on follow up. T1, proton and T2 weighted axial images were obtained with additional 5 mmthick T1-weighted sagittal and coronal images to evaluate the morphology and size of the mammillary body.
@ES Results.
@EN Increased T2 signal was seen in the periaqueductal area in seven 9sometimes involving superior colliculus); medial thalamus in five; and splenium of the corpus callosum in two. Among the seven patients with T2 signal abnormalities, five had
follow-up MRI in 2 to 70 days, which showed complete resolution of the abnormalities. Seven patients showed atrophy of mammillary body on the initial MRI. In the three patients who ahd normal mammillary body in size on initial scans, follow-up
MRI
revealed atrophic change of mammillary body in size on initial scans, follow-up MRI revealed atrophic change of mammillary body. T1-weighted sagittal image showed superior cerebellar vermis atrophy in seven. Four patients revealed dilatation of
the
third ventricle.
@ES Conclusion.
@EN MRI findings of Wernicke encephalopathy appear diagnostic in acute stage and may reflect the pathological evolution in acute and chronic phases of Wernicke-Korsakoff syndrome.
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