Baló's concentric sclerosis and its radiographic alterations: case report

Case Presentation- Baló's concentric sclerosis is a rare variant of a severe monophasic demyelinating disease characterized radiologically by concentric rings of demyelination and remyelination, with a tumefactive presentation which might be confused with other mass effect lesions. The objective is to report a 24-year-old female patient with Baló’s concentric sclerosis and its difficult diagnosis. The patient had an unusual acute onset of left-side pyramidal hemiparesis. On magnetic resonance imaging of the skull, lesions compatible with demyelinating foci in the acute phase were visualized in the right corona radiata close to the callosal-septal interface, with the appearance of concentric sclerosis of Baló and in the subcortical white matter of the right parietal lobe. Treated with methylprednisolone and plasmapheresis. At magnetic resonance imaging, there was a regression of the dimensions and signs of activity of demyelinating lesions and the patient was discharged with preserved motricity and sensitivity. Discussion – diagnosing ECB can be difficult as the symptoms often overlap with other neurological conditions. Imagings tests, such as brain MRI, are often used to aid in the correct diagnosis. Final Comments- distinguishing tumefactive demyelinating lesions from other diseases is fundamental for the adequate and eartly treatment to the patient, being essential a quality image for the same.