Schilder disease

  • Acute or subacute disorder
  • Specific clinicoradiological presentation of multiple sclerosis
  • Affects children, young adults
  • Psychiatric predominance, acute intracranial hypertension, intermittent exacerbations, progressive deterioration
  • Well demarcated demyelination, reactive gliosis, relative sparing of axons
  • Microcystic changes, frank cavitation
  • Dramatic response to steroids
Imaging
  • Ring enhancing lesions in both hemispheres
  • Symmetric, in parieto-occipital regions
  • Minimal mass effect
  • Restricted diffusion
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Sarbu, Nicolae, et al. “White matter diseases with radiologic-pathologic correlation.” Radiographics 36.5 (2016): 1426-1447.