Sohei Yoshimura1, Tetsuro Ago2, Masatoshi Koga3, Masahiro Kamouchi4, Takanari Kitazono2. 1. Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan. Electronic address: sohei-y@ncvc.go.jp. 2. Department of Nephrology, Hypertension, and Strokology, Kyushu University Hospital, Fukuoka, Japan; Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. 3. Division of Cerebrovascular Medicine and Neurology, National Cerebral and Cardiovascular Center, Suita, Japan. 4. Department of Nephrology, Hypertension, and Strokology, Kyushu University Hospital, Fukuoka, Japan; Department of Health Care Administration and Management, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Abstract
BACKGROUND: Involvement of central nervous system is very common in Behçet disease, known as neuro-Behçet disease (NBD). However, there have been few reports which evaluated stroke-like cerebral small-vessel disease associated with Behçet disease. OBJECTIVE: We evaluated cerebral small-vessel lesions by using magnetic resonance imaging in 2 patients with NBD. CLINICAL CASES: In a 41-year-old woman case, who developed dysarthria and left hemiparesis, diffusion-weighted images (DWI) showed small high-intensity areas in the bilateral internal capsule. The right lesion had a low apparent diffusion coefficient (ADC) value, whereas the left one had a high value. In a 59-year-old woman case, who developed dysarthria and left hemihypesthesia, DWI showed high-intensity areas in the right side of the pons and in the right peduncle of the midbrain. The lesion in the pons had a low ADC value, whereas the lesion in the midbrain had a high value. ADC map may be useful to identify symptomatic lesions in the brain, because only the lesions with low ADC values were symptomatic. CONCLUSIONS: NBD should be considered in those who had not had any risk factors for ischemic stroke but experienced cerebral small-vessel disease.
BACKGROUND: Involvement of central nervous system is very common in Behçet disease, known as neuro-Behçet disease (NBD). However, there have been few reports which evaluated stroke-like cerebral small-vessel disease associated with Behçet disease. OBJECTIVE: We evaluated cerebral small-vessel lesions by using magnetic resonance imaging in 2 patients with NBD. CLINICAL CASES: In a 41-year-old woman case, who developed dysarthria and left hemiparesis, diffusion-weighted images (DWI) showed small high-intensity areas in the bilateral internal capsule. The right lesion had a low apparent diffusion coefficient (ADC) value, whereas the left one had a high value. In a 59-year-old woman case, who developed dysarthria and left hemihypesthesia, DWI showed high-intensity areas in the right side of the pons and in the right peduncle of the midbrain. The lesion in the pons had a low ADC value, whereas the lesion in the midbrain had a high value. ADC map may be useful to identify symptomatic lesions in the brain, because only the lesions with low ADC values were symptomatic. CONCLUSIONS: NBD should be considered in those who had not had any risk factors for ischemic stroke but experienced cerebral small-vessel disease.