Sarcoidosis

            Sarcoidosis is a granulomatous disease of unknown etiology. In approximately 5% of cases, the CNS is involved as a granulomatous infiltration of the meninges and underlying parenchyma, most notably at the base of the brain. It may also affect cranial or peripheral nerves as isolated disease. Cranial nerve palsies, chronic meningitis and hypothalamic- pituitary dysfunction are frequent manifestations.

            MR is well suited to imaging the focal pituitary/hypothalamic lesions and white matter lesions that have been noted in these patients. The basal cisterns may enhance in patients with meningeal sarcoidosis, but a nodular pattern usually distinguishes it from the infectious varieties. A particularly interesting form of meningeal sarcoid results in thick meningeal plaques, often over the convexities. These may mimic meningiomas in that they remain isointense or hypointense relative to cortex on T2- as well as T1-weighted images. Endnote , Endnote

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