Computer assisted tomography in adrenoleukodystrophy.

Our findings on computer assisted tomography of the brain in four cases of adrenoleukodystrophy are sufficiently consistent to warrant delineation. Early changes, which may predate obvious clinical findings, are represented by areas of decreased attenuation coefficient in the posterior (parieto-occipital) white matter around the trigonum of each lateral ventricle. Subsequently the temporal, parietal, and frontal lobes are involved, and the extensive areas of decreased attenuation coefficient in the white matter become almost indistinguishable from the conspicuously enlarged ventricles. Only a thin ependymal wall separates the ventricular cavities from the leukomalacia lesions. Contrast medium enhancement at the periphery of the affected regions is an important, although inconsistent, feature.