Deficiency of vitamin B12 may produce neuropsychiatric disturbances. In the CNS the disease affects mainly myelin sheaths, and the spongy degeneration and diffuse demyelination of the posterior and lateral columns of the spinal cord are the classical pathological changes in patients with subacute combined degeneration. Similar changes also occur in cerebral hemispheres and MRI abnormalities in brain of such patients could be expected, but have received little attention. We report a case of pernicious anemia with neurological manifestations and brain MRI abnormalities. We discuss the neuropathological aspects and we suggest that pernicious anemia is a differential diagnosis to consider in central demyelinating lesions at MRI.
pernicious anemia; cobalamin; brain MRI
