Primary necrosis of corpus callosum with dystrophic astrogliosis and Rosenthal-like fiber formation. The first Chinese case of Marchiafava-Bignami's disease (MBD)

Alzheimer Type I Astrocytes: Still Mysterious Cells

Over 100 years ago, von Hösslein and Alzheimer described enlarged and multinucleated astrocytes in the brains of patients with Wilson disease. These odd astrocytes, now well known to neuropathologists, are present in a large variety of neurological disorders, and yet the mechanisms underlying their generation and their functional attributes are still not well understood. They undergo abnormal mitoses and fail to accomplish cytokinesis, resulting in multinucleation. Oxidative stress, hypoxia, and inflammation may be contributing pathologies to generate these astrocytes. The abnormal mitoses occur from changes in cell shape, the accumulation of cytoplasmic proteins, and the mislocalization of many of the important molecules whose coordination is necessary for proper mitotic spindle formation. Modern technologies will be able to characterize their abnormalities and solve century old questions of their form and function.

Marchiafava-Bignami disease in a trauma patient

Marchiafava-Bignami disease (MBD) is a rare pathological condition affecting the corpus callosum (CC), characterized by progressive demyelination and necrosis. While usually found in patients with chronic alcoholism, it has rarely been characterized in non-alcoholics. We describe a trauma patient with an unknown mechanism of injury, who was found to have MBD after remaining comatose for a prolonged period of time. Magnetic resonance imaging (MRI) demonstrated restricted diffusion involving the genu, body, and splenium of the CC. The patient eventually awoke but was non-communicative and uncomprehending prior to discharge to a nursing facility. We reviewed the literature and report here the first case of MBD encountered in a trauma patient. In conclusion, MBD is an extremely rare condition in non-alcoholic patients, and the use of MRI is crucial for its identification.

Non-Alcoholic Partially Reversible Marchiafava-Bignami Disease: Review and Relation with Reversible Splenial Lesions

Marchiafava-Bignami disease (MBD) is a rare pathological condition characterized by progressive demyelination and necrosis of the corpus callosum (CC). MBD occurs in patients with chronic alcoholism although a few non-alcoholic cases have been reported. We describe a non-alcoholic, depressed patient, who developed MBD after psycho-active drug abuse. Magnetic resonance imaging (MRI) disclosed bilateral, symmetric, hyperintense regions in the genu, body and splenium of the CC associated with increased water diffusivity. Clinical and MRI findings showed a partial recovery after tapering/modification of psycho-active drugs. We reviewed the nine cases of non-alcoholic MBD reported in the literature. We conclude that most cases should have been diagnosed as a reversible isolated splenial lesion (MERS), a recently described condition semiotically similar to MBD but with a specific localization, restricted water diffusivity and reversibility at MRI. In conclusion, MBD is an extremely rare condition in non-alcoholic patients and the use of MRI for distinguishing between MBD and MERS is crucial.

[Primary necrosis of the corpus callosum (Marchiafava-Bignami's disease): report of 5 cases]

The clinicopathological study of five autopsied cases of Marchiafava-Bignami disease is reported. The demyelination of the central portion of the corpus callosum is the major characteristics of the disease. In two cases the demyelination also involved the anterior and posterior commissures. There is a clear relationship to alcoholism and malnutrition in the cases reported in the present study.