{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T13:34:31Z","timestamp":1770989671566,"version":"3.50.1"},"reference-count":8,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background:<\/jats:title>\n Marchiafava\u2013Bignami disease (MBD) is a rare alcohol-related disorder that predominantly affects the corpus callosum. Because MBD frequently demonstrates diffusion restriction on magnetic resonance imaging (MRI), it can closely mimic acute ischemic stroke (AIS), posing a diagnostic challenge in image-driven acute stroke evaluation. Early recognition is crucial, as timely thiamine therapy may result in complete clinical and radiologic recovery.<\/jats:p>\n <\/jats:sec>\n \n Case Description:<\/jats:title>\n A 38-year-old man with long-standing daily consumption of shochu, a Japanese distilled spirit, developed vertigo and vomiting on awakening, followed by mild right lower extremity weakness on day 5. MRI performed at a local clinic on day 6 revealed a diffusion-restricted lesion confined to the splenium of the corpus callosum, and corpus callosum infarction was initially suspected. On admission, the patient was fully conscious and exhibited horizontal gaze-evoked nystagmus with very mild right-sided weakness. MRI identified a splenial lesion of the corpus callosum exhibiting high signal intensity on diffusion-weighted imaging with corresponding low apparent diffusion coefficient values, accompanied by mild hyperintensity on T2-weighted and fluid-attenuated inversion recovery images. Given the patient\u2019s young age, absence of vascular risk factors, and the splenial distribution of the lesion, AIS was considered unlikely. Following consultation with a neurologist, MBD was suspected based on the patient\u2019s history of chronic alcohol consumption, and intravenous vitamin supplementation, including thiamine, was initiated. Neurological symptoms improved rapidly, and follow-up MRI on hospital day 8 demonstrated complete resolution of the splenial lesion. The patient was discharged without neurological sequelae on hospital day 10.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n A diffusion-restricted splenial lesion in patients with a history of chronic alcohol consumption and without vascular risk factors should prompt consideration of MBD rather than a reflexive diagnosis of AIS. Careful integration of imaging findings with clinical context is essential for identifying reversible stroke mimics and ensuring timely, appropriate treatment.<\/jats:p>\n <\/jats:sec>","DOI":"10.25259\/sni_1422_2025","type":"journal-article","created":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T12:28:47Z","timestamp":1770985727000},"page":"91","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Marchiafava\u2013Bignami disease mimicking acute corpus callosum infarction associated with chronic shochu consumption"],"prefix":"10.25259","volume":"17","author":[{"given":"Yuhei","family":"Michiwaki","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Gyotoku General Hospital, Ichikawa, Chiba, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin","family":"Nishimiya","sequence":"additional","affiliation":[{"name":"Department of Neurology, Gyotoku General Hospital, Ichikawa, Chiba, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takahiro","family":"Kumagawa","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Gyotoku General Hospital, Ichikawa, Chiba, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryo","family":"Kajiwara","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Gyotoku General Hospital, Ichikawa, Chiba, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yusuke","family":"Takamine","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Gyotoku General Hospital, Ichikawa, Chiba, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chihiro","family":"Yagi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Gyotoku General Hospital, Ichikawa, Chiba, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryo","family":"Otaki","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Gyotoku General Hospital, Ichikawa, Chiba, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takuji","family":"Igarashi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Gyotoku General Hospital, Ichikawa, Chiba, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seiichiro","family":"Mine","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Gyotoku General Hospital, Ichikawa, Chiba, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2026,2,13]]},"reference":[{"key":"10.25259\/SNI_1422_2025\/ref-1","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1111\/j.1552-6569.2007.00202.x","article-title":"The value of diffusion-weighted imaging in the diagnosis of 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