Toxins in Brain! Magnetic Resonance (MR) Imaging of Toxic Leukoencephalopathy – A Pictorial Essay

Summary Toxic leukoencephalopathy results from damage to the white matter caused by various toxins. It manifests itself as white matter signal abnormalities with or without the presence of restricted diffusion. These changes are often reversible if the insulting agent is removed early, with the exception of posthypoxic leukoencephalopathy that can manifest itself 1–2 weeks after the initial insult. However, many other potential causes of white matter signal abnormalities can mimic the changes of toxic leukoencephalopathy. Thus, familiarity with the causes, clinical presentation and particularly imaging findings of toxic leukoencephalopathy is critical for early treatment and improved prognosis. The purpose of this pictorial essay is to familiarize the reader with the various causes of toxic leukoencephalopathy along with its differential diagnoses and mimics.

[1]  G. Enríquez,et al.  Side effects of oncologic therapies in the pediatric central nervous system: update on neuroimaging findings. , 2011, Radiographics : a review publication of the Radiological Society of North America, Inc.

[2]  C. Soh,et al.  Reversible delayed posthypoxic leukoencephalopathy. , 2006, AJNR. American journal of neuroradiology.

[3]  C Gössl,et al.  Differential lesion patterns in CADASIL and sporadic subcortical arteriosclerotic encephalopathy: MR imaging study with statistical parametric group comparison. , 2001, Radiology.

[4]  Cheng-Yu Chen,et al.  Brain injury after acute carbon monoxide poisoning: early and late complications. , 2007, AJR. American journal of roentgenology.

[5]  Amélia Mendes,et al.  Brain magnetic resonance in status epilepticus: A focused review , 2016, Seizure.

[6]  W. Smoker,et al.  Diffusion-weighted imaging of acute excitotoxic brain injury. , 2005, AJNR. American journal of neuroradiology.

[7]  Y. Ge.  Multiple sclerosis: the role of MR imaging. , 2006, AJNR. American journal of neuroradiology.

[8]  W. Bartynski.  Posterior Reversible Encephalopathy Syndrome, Part 1: Fundamental Imaging and Clinical Features , 2008, American Journal of Neuroradiology.

[9]  J. Smirniotopoulos,et al.  From the archives of the AFIP: central nervous system infections associated with human immunodeficiency virus infection: radiologic-pathologic correlation. , 2008, Radiographics : a review publication of the Radiological Society of North America, Inc.

[10]  W P Dillon,et al.  Radiation injury of the brain. , 1991, AJNR. American journal of neuroradiology.

[11]  J. Chi,et al.  Leukodystrophy in children: a pictorial review of MR imaging features. , 2002, Radiographics : a review publication of the Radiological Society of North America, Inc.

[12]  Yogesh Kumar,et al.  Progressive Multifocal Leukoencephalopathy in a 62-Year-Old Immunocompetent Woman , 2014, Case reports in neurological medicine.

[13]  Se Jeong Jeon,et al.  Uremic Encephalopathy with Atypical Magnetic Resonance Features on Diffusion-Weighted Images , 2012, Korean journal of radiology.

[14]  B. Tamrazi,et al.  Your brain on drugs: imaging of drug-related changes in the central nervous system. , 2012, Radiographics : a review publication of the Radiological Society of North America, Inc.

[15]  J. Chi,et al.  Gliomatosis cerebri: comparison of MR and CT features. , 1993, AJR. American journal of roentgenology.

[16]  A. Erbetta,et al.  Case 159: cerebral amyloid angiopathy-related inflammation. , 2010, Radiology.