Cranial Magnetic Resonance Imaging Findings in Patients with Neuro-Behcet's Syndrome
Füsun Mayda Domaç1, Ece Boylu2, Handan Mısırlı1, Tuğrul Adıgüzel1, Temel Özden1, Ayşegül Ertorun1
1Haydarpaşa Numune Training ve Research Hospital,İstanbul
2GATA Haydarpaşa Training Hospital, İstanbul
Keywords: Behcet syndrome, magnetic resonance imaging.
Abstract
OBJECTIVE: Behcet’s disease is a multisystemic, vascular-inflammatory disease of unknown origin. Impairment of the central nervous
system is rare, and young adults can present with brain stem syndrome or hemiparesis. In this study, we aimed to determine the cranial
magnetic resonance imaging (MRI) patterns in patients diagnosed as parenchymal or nonparenchymal neuro-Behcet’s syndrome
who did not have headache.
METHODS: Thirty-eight patients admitted to the Haydarpasa Numune Training and Research Hospital, Department of
1st Neurology and GATA Haydarpasa Training Hospital Neurology Department, Istanbul between 2003 and 2009 in the acute period
and with the diagnosis of neuro-Behcet’s syndrome were investigated. All the patients were examined by routine hematological
and biochemical blood tests, vasculitis tests, cranial MRI, and magnetic resonance venography if needed. Patients with headache and
those without cranial MRI lesions were excluded.
RESULTS: Eighteen patients, with a mean age of 34.6 ± 9.7 and age range of 17-51, were investigated. Eleven of the patients were
male and seven were female. In 14 patients, the diagnosis of Behcet’s disease was present for 11.5 years, while four patients were
newly diagnosed after admission. The most common complaints were hemiparesis, dysarthria and diplopia due to the cranial nerve
involvement. Twelve of the patients were admitted with the first attack, five with the second attack and one with the third attack in
the acute period. Sixteen patients with parenchymal neuro-Behcet’s syndrome had a total of 41 lesions, and the brain stem was the
most common localization (55.6%). Of the two patients with nonparenchymal neuro-Behcet’s syndrome, thrombosis was observed
in the superior sagittal sinus in one and in the transverse sinus in the other.
CONCLUSION: Cranial MRI is a sensitive diagnostic technique for neuro-Behcet’s syndrome. MRI is a noninvasive diagnostic tool to confirm
the involvement of the central nervous system and has an important role in confirming the stage of the illness in Behcet’s disease.