MRI has shown that patients with KS have an increase in cerebrospinal fluid volume and widespread gray matter volume deficits.5,64 Moreover, group analysis has revealed substantial volume changes in the mamillary bodies of individuals with KS,65,66 although mamillary body shrinkage is not a necessary concomitant of this condition.3,67 MRI has also demonstrated volume losses in the orbito-frontal cortices and other hypothalamic nuclei in KS.5 The volume losses that best differentiate KS from uncomplicated alcoholism, however, involve the thalamus.68 In acute WE, MRI can be used to detect symmetrical, bi lateral hyperintense foci (clearly visible on T2-weighted and fluid-attenuated inversion recovery images) in peri-aqueductal gray matter, the mamillary bodies, and the tissue surrounding the third ventricle.5,69
