7 Tesla MRI demonstrates vascular pathology in Baló’s concentric sclerosis

• Published in: Multiple sclerosis Vol. 19; no. 1; pp. 120 - 122
• Main Authors: Berghoff, M, Schlamann, MU, Maderwald, S, Grams, AE, Kaps, M, Ladd, ME, Gizewski, ER
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01-01-2013; Sage Publications; Sage Publications Ltd
• Subjects: Antibodies, Monoclonal, Humanized - therapeutic use; Biological and medical sciences; Brain - pathology; Data processing; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Diffuse Cerebral Sclerosis of Schilder - pathology; Female; Humans; Immunologic Factors - therapeutic use; Magnetic Resonance Imaging - methods; Medical sciences; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis; Natalizumab; Neurology; Young Adult; magnetic resonance imaging; multiple sclerosis; Baló’s concentric sclerosis; magnetic resonance spectroscopy; plasma exchange; natalizumab; microhaemorrhages; Nervous system diseases; Multiple sclerosis; Natalizumab; Cardiovascular disease; NMR spectrometry; Nuclear magnetic resonance imaging; Inflammatory disease; Plasma exchange; Central nervous system disease; Baló's concentric sclerosis; Degenerative disease
• ISSN: 1352-4585; 1477-0970
• DOI: 10.1177/1352458512445302

Baló’s concentric sclerosis (BCS) is an inflammatory demyelinating disease related to multiple sclerosis; its underlying pathology remains unclear. At 7 T MRI in a 19-year-old female BCS patient, microhaemorrhages and ectatic veins were found in T2 hyperintense regions, features which have not been previously reported in conjunction with BCS, and these findings may support the view that vascular pathology plays a role in BCS. MRS data suggest that neuron loss and lipid turnover still took place months after a remission. Plasma exchange was effective in treating a relapse with severe motor deficits, and the off-label use of natalizumab was successful in maintaining remission in this patient.