Memory loss and confusion ? encephalitis. Background of chronic alcohol excess
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Bilateral mammillary body signal abnormality with contrast enhancement.
Mildly increased FLAIR signal around the cerebral aqueduct.
There is an incidental small colloid cyst within the foramen of Monro.
Wernicke encephalopathy is related to thiamine deficiency and is associated with excessive alcohol intake. Classic imaging features include symmetrical increased T2/FLAIR signal involving the mammillary bodies, and can also involve the dorsomedial thalami, tectal plate, periaqueductal area, and around the third ventricle. The usual clinical presentation is with the triad of confusion, ataxia, and ophthalmoplegia.