Neuroimaging and the lesion of multiple sclerosis

• Published in: American journal of neuroradiology : AJNR Vol. 8; no. 3; pp. 549 - 552
• Main Authors: Poser, CM, Kleefield, J, O'Reilly, GV, Jolesz, F
• Format: Journal Article
• Language: English
• Published: Oak Brook, IL Am Soc Neuroradiology 01-05-1987; American Society of Neuroradiology
• Subjects: Adult; Biological and medical sciences; Brain - diagnostic imaging; Brain - pathology; Case Reports; Contrast Media - administration & dosage; Female; Humans; Magnetic Resonance Spectroscopy; Medical sciences; Multiple Sclerosis - diagnosis; Multiple Sclerosis - diagnostic imaging; Multiple Sclerosis - drug therapy; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis; Neurology; Prednisone - therapeutic use; Tomography, X-Ray Computed; Human; Chemotherapy; Multiple sclerosis; Nervous system diseases; ACTH; Brain (Vertebrata); Computerized axial tomography; High dose; Contrast media
• ISSN: 0195-6108; 1936-959X

In a patient with long-standing multiple sclerosis (MS), a double-dose delayed contrast-enhanced CT scan obtained during exacerbation revealed many areas of enhancement. Vigorous treatment with corticotropic hormone was followed by almost complete disappearance of these abnormalities. No areas of low attenuation were seen on a later unenhanced CT scan. Finally, MR imaging showed only a single area compatible with a plaque of MS. It is suggested that pathologic alteration of the blood-brain barrier seen in MS is not necessarily followed by demyelination and plaque formation. Restoration of the integrity of the blood-brain barrier may thus possibly prevent the formation of plaques in some MS patients, in particular if this can be accomplished early in the course of the exacerbation.