MRI findings Wernicke's encephalopathy

Diffusion-weighted imaging (A) and ADC map (B) show restricted diffusion in the thalami, suggestive of cytotoxic edema. Other reports show hyperintensity on diffusion images without restriction seen on ADC maps, more suggestive of vasogenic edema. The underlying pathology and prognostic significance of diffusion findings are unclear. Post-contrast images (C) indicate breakdown of the blood-brain barrier with enhancement of the mammillary bodies. Courtesy Eric D Schwartz, MD.