Neuroradiological findings in Behcet's disease

Purpose: We present the typical neuroradiological findings in three patient s with neuro-Behcet in comparison with a review of neuroradiological and hi stopathological findings described in the literature. Material and Methods: In three male patients aged 32-57 years with Behcet's disease and neurolog ical symptoms cranial CT and MRI studies were carried out. Findings were mo nitored over a period of 6-18 months. Additionally; cerebral and renal DSA were performed in two patients. Results: In two patients we found acute inf lammatory lesions located in the brainstem and the periventricular white ma tter, some of which were associated with an acute inflammatory disruption o f the blood-brain barrier. Lesions decreased in size under treatment, but c omplete resolution was not consistently noted. In the third patient we foun d a thrombosis of the superior sagittal sinus but no other intracranial abn ormalities. Conclusions: Our findings agree with those described in the lit erature as being typical of Behcet's disease. Inflammatory lesions most com monly occur in the brain stem, followed by the basal ganglia and the cortex and white matter of both the cerebrum and cerebellum. In contrast to venou s sinus thrombosis, brainstem atrophy and cortical or cerebellar lesions, w hite matter lesions have little diagnostic value, irrespective of their loc ation. The definitive diagnosis of Behcet's disease is made on the basis of clinical criteria.