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Neurological involvement is one of the most devastating manifestations of Behçet's disease.1 However, the pathogenic mechanism for CNS lesions in patients with neuro-Behçet's disease is unclear. Although vasculitis is usually considered to be the central pathological feature in Behçet's disease, a vasculitic process was not usually demonstrated in the CNS.2
Diffusion weighted imaging can detect changes in water diffusion associated with cellular dysfunction. It has been well documented that acute infarction related to cytotoxic oedema is characterised by a marked decrease in diffusion, and also that increased interstitial water related to vasogenic oedema shows increased diffusion.3 Conventional MRI cannot distinguish between these different types of oedema. We report on a patient with neuro-Behçet's disease with a significantly reversible T2 signal and diffusion abnormalities in CNS lesions.
A 54 year old Asian man was admitted with dysarthria and left hemiparesis, which evolved over a period of 2 days and was associated with gradual mental …