Marchiafava–Bignami disease is a progressive neurological disease of alcohol use disorder, characterized by corpus callosum demyelination and necrosis and subsequent atrophy. The disease was first described in 1903 by the Italian pathologists Amico Bignami and Ettore Marchiafava in an Italian Chianti drinker. In this autopsy, Marchiafava and Bignami noticed that the middle two-thirds of the corpus callosum were necrotic. It is very difficult to diagnose and there is no specific treatment. Until 2008 only around 300 cases had been reported. If caught early enough, most patients survive. Symptoms and signs
Symptoms can include, but are not limited to lack of consciousness, aggression, seizures, depression, hemiparesis, ataxia, apraxia, coma, etc. There will also be lesions in the corpus callosum. Causes
It is classically associated with chronic alcoholism especially with red wine consumption and sometimes associated nutritional deficiencies. Alcohol use disorder can also cause thiamine deficiency, which is also observed to cause MBD. Mechanism
Individuals with MBD usually have a history of excessive alcohol consumption, but this is not always the case. The mechanism of the disease is not completely understood, but it is believed to be caused by a Vitamin B deficiency, malnutrition, or alcohol use disorder. The damage to the brain can extend into neighboring white matter and sometimes go out as far as subcortical regions. Diagnosis
Marchiafava–Bignami disease is routinely diagnosed with the use of an MRI because the majority of clinical symptoms are non-specific. Before the use of such imaging equipment, it was unable to be diagnosed until autopsy.
A Bartons fracture is a type of wrist injury where there is a broken bone associated with a dislocated bone in the wrist, typically occurring after falling on top of a bent wrist. It is an intra-articular fracture of the distal radius with dislocation of the radiocarpal joint.There exist two types of Bartons fracture – dorsal and palmar, the latter being more common. The Bartons fracture is caused by a fall on an extended and pronated wrist increasing carpal compression force on the dorsal rim. Intra-articular component distinguishes this fracture from a Smiths or a Colles fracture. Treatment of this fracture is usually done by open reduction and internal fixation with a plate and screws, but occasionally the fracture can be treated conservatively. Eponym
It is named after John Rhea Barton (1794–1871), an American surgeon who first described this in 1838. Additional images
References
External links
01217 at CHORUS