Mri Brain in Alcohol-related Neurological Disorders: a Pictorial Essay with Emphasis on Diffusion-weighted Imaging and Arterial Spin Labeling

Bhawana Sonawane; Pooja Chavan; Himanshu Sekhar Behera

Mri Brain in Alcohol-related Neurological Disorders: a Pictorial Essay with Emphasis on Diffusion-weighted Imaging and Arterial Spin Labeling

Author(s)	Prof. Bhawana Sonawane, Dr. Pooja Chavan, Dr. Himanshu Sekhar Behera
Country	India
Abstract	Background and Objectives Alcohol Use Disorder (AUD) and acute alcohol intoxication are associated with a wide spectrum of neurological complications resulting in structural and functional alterations within the brain. Magnetic Resonance Imaging (MRI) plays a pivotal role in the diagnosis and characterization of these abnormalities. This pictorial essay aims to illustrate the diverse neuroimaging manifestations of alcohol-related brain injury and highlight the role of Arterial Spin Labeling (ASL) and Diffusion-Weighted Imaging (DWI) in evaluating cerebral perfusion and diffusion changes. Methods A retrospective review of MRI brain examinations of 50 patients with a history of chronic alcohol use or acute alcohol intoxication was performed. Conventional MRI sequences along with DWI and ASL perfusion imaging were assessed for alcohol-related neurological complications including chronic alcohol-related brain atrophy, Wernicke encephalopathy, Marchiafava-Bignami disease, hepatic encephalopathy, osmotic demyelination syndrome, cerebral venous sinus thrombosis, hypoxic encephalopathy, and post-ictal changes. Results Among the 50 patients, chronic alcohol-related brain injury was identified in 34 (68%), with cerebral cortical atrophy (62%) and white matter volume loss (56%) representing the most common findings. Cerebellar atrophy was present in 36% of patients. Acute alcohol-related encephalopathies were observed in 16 (32%) patients. Wernicke encephalopathy was the most frequently encountered acute complication (14%), followed by hepatic encephalopathy (10%), osmotic demyelination syndrome (8%), and Marchiafava-Bignami disease (6%). ASL imaging demonstrated altered cerebral perfusion patterns and DWI revealed restricted diffusion in acute encephalopathies corresponding to cytotoxic edema. Conclusion MRI effectively demonstrates the broad spectrum of alcohol-related brain abnormalities, ranging from chronic neurodegenerative changes to acute potentially reversible encephalopathies. DWI and ASL perfusion imaging provide valuable complementary information and may enhance the assessment of alcohol-induced neurological disorders.
Keywords	Alcohol Use Disorder, MRI Brain, Wernicke Encephalopathy, Marchiafava-Bignami Disease, Hepatic Encephalopathy, Arterial Spin Labeling, Diffusion-Weighted Imaging, Alcohol-Related Brain Injury.
Field	Medical / Pharmacy
Published In	Volume 8, Issue 4, July-August 2026
Published On	2026-07-31

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Mri Brain in Alcohol-related Neurological Disorders: a Pictorial Essay with Emphasis on Diffusion-weighted Imaging and Arterial Spin Labeling

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