Cerebral Small-Vessel Disease in Neuro-Behçet Disease

Background: Involvement of central nervous system is very common in Behçet disease, known as neuro-Behçet disease (NBD). However, there have been few reports which evaluated stroke-like cerebral small-vessel disease associated with Behçet disease.

Objective: We evaluated cerebral small-vessel lesions by using magnetic resonance imaging in 2 patients with NBD.

Clinical cases: In a 41-year-old woman case, who developed dysarthria and left hemiparesis, diffusion-weighted images (DWI) showed small high-intensity areas in the bilateral internal capsule. The right lesion had a low apparent diffusion coefficient (ADC) value, whereas the left one had a high value. In a 59-year-old woman case, who developed dysarthria and left hemihypesthesia, DWI showed high-intensity areas in the right side of the pons and in the right peduncle of the midbrain. The lesion in the pons had a low ADC value, whereas the lesion in the midbrain had a high value. ADC map may be useful to identify symptomatic lesions in the brain, because only the lesions with low ADC values were symptomatic.

Conclusions: NBD should be considered in those who had not had any risk factors for ischemic stroke but experienced cerebral small-vessel disease.