Neurocutaneous melanosis clinical presentation is multifactorial and can include skin and neurological findings, such as hydrocephalus, neuropsychological development delay, psychiatric disorders, cranial nerve palsies, intracranial hemorrhage and myelopathy.
The classic MRI finding include hyperintense areas in the temporal lobes on T1-weighted images. Diffuse leptomeningeal enhancement of the brain and spine, and mass of malignant melanoma can also be demonstrated.
The lesions usually exhibit a high signal intensity on T1-weighted images and do not show enhancement after contrast. They tipically occur in the amygdaloid nuclei, cerebellum or pons.
Leptomeningeal carcinomatosis, meningitis, subarachnoid hemorrhage, non-melanocytic hemorrhagic tumors and other melanin-containing lesions are potential differential diagnoses that can be characterized by MRI images of the brain.