Images in clinical medicine. Balo's concentric sclerosis.

摘要

A25-YEAR-OLD, LEFT-HANDED MAN WITH KNOWN RELAPSING-REMITTING multiple sclerosis presented with a mild, nonfluent aphasic syndrome and left facial paresis that had developed within the previous 5 days. Magnetic resonance imaging (MRI) scans of the brain revealed a large lesion with a concentric-ring pattern consisting of alternating bands of higher and lower signal intensity (Panel A, axial T2-weighted image; Panel B, sagittal image). Although large in diameter, the lesion had only a minor mass effect. Balo's concentric sclerosis, described in 1928 by Joszef Balo as a variant of acute multiple sclerosis, is histopatho-logically characterized by alternating layers of myelinated and demyelinated tissue. On MRI, Balo-like lesions are defined as two or more alternating bands of differing signal intensities.