Contribution of MRI in the Management of Neuro-Behçet, Retrospective Study: About 16 Cases

Abstract

Neurological damage from Behçet's disease is considered to be a severe neurological manifestation. We have collected 16 cases from the internal medicine, neurology and radiology department of Ibnou Rochd hospital in Casalanca. Our patients have a mean age of 39 years, with male predominance and an average delay of 6.18 years. Headache and central motor impairment were the first telltale signs of neuro-Behçet in 62.5%. The brain scan was carried out in 15 patients, it objectified an ischemic stroke in a single case, poorly systematized hypodensities raising suspicion of thrombophlebitis in 5 cases and an image of venous thrombosis concerning the upper longitudinal sinus in a single case. Brain MRI showed demyelination lesions, of infra-centimeter sizes and variable shapes; in hypo signal T1, hyper signal T2 and T2 FLAIR in 9 patients, of supratentorial seat in 5 cases and lesions in under tentorial in 4 cases with uptake of nodular contrast in 2 cases and annular contrast in only one case. The MRI also highlighted 3 cases of cortical subcortical atrophy on the upper tentorial level, one case of atrophy of the brainstem, 7 cases of venous thrombosis objectified on angio MRI and 2 cases of stroke ischemic. Thus, a pseudo-tumor aspect was reported in only one case. And only one case benefited from a spinal MRI and objectified cervical lesions. These lesions are often associated. The preferred location found in our patients is the brainstem, essentially ponto- mesencephalic. This distribution makes it possible to make the differential diagnosis with other vasculitides and inflammatory diseases.