Purpose: We present the typical neuroradiological findings in three patients with neuro-Behçet in comparison with a review of neuroradiological and histopathological findings described in the literature.
Material and methods: In three male patients aged 32-57 years with Behçet's disease and neurological symptoms cranial CT and MRI studies were carried out. Findings were monitored over a period of 6-18 months. Additionally, cerebral and renal DSA were performed in two patients.
Results: In two patients we found acute inflammatory lesions located in the brainstem and the periventricular white matter, some of which were associated with an acute inflammatory disruption of the blood-brain barrier. Lesions decreased in size under treatment, but complete resolution was not consistently noted. In the third patient we found a thrombosis of the superior sagittal sinus but no other intracranial abnormalities.
Conclusions: Our findings agree with those described in the literature as being typical of Behçet's disease. Inflammatory lesions most commonly 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 venous sinus thrombosis, brainstem atrophy and cortical or cerebellar lesions, white matter lesions have little diagnostic value, irrespective of their location. The definitive diagnosis of Behçet's disease is made on the basis of clinical criteria.