Utilizing 7T MRI in Labrune Syndrome: Case Report and Review

Introduction: Labrune syndrome is a rare disease characterized by microangiopathy leading to recurrent hemorrhage and cyst formation in the white matter tracts of the brain. The diagnosis is based on radiographic imaging of calcified cysts, and treatment most commonly involves surgical resection, antiepileptic medications, and antipsychotics for symptom relief. Due to limited cases and follow-up times, understanding of the progression of this disease is poor. This report explores the progression of Labrune syndrome over a 16-year case and explore the potential benefits of 7T MRI images for decision making in this rare brain lesion disorder.

Methods: We completed a literature review in PubMed, Scopus, and Web of Science related to Labrune syndrome. We summarized our findings below and reported a case of Labrune syndrome with a 16 year follow-up and imaging with a 7T MRI.

Results: This case involves a 39-year-old male that was originally diagnosed with Labrune syndrome in 2009 at the age of 23 after a generalized tonic-clonic seizure. At the time, he had undergone a craniotomy to resect the main calcified cyst and repeat MRIs remained stable for six years. However, the patient began to experience recurrent headaches and eventually vision changes and muscle weakness. A shunt was placed due seven years post-diagnosis due to mass effect from the cystic changes, and he underwent another resection in 2020. He continues to have recurrent headaches and seizures. A 7T MRI was completed to further evaluate potential benefits of another procedure. A literature review about Labrune syndrome returned only 92 reported cases, and these are limited by short follow-up times and limited long-term treatments.

Conclusion : This case report demonstrates the progression of Labrune syndrome, which is not well reported in the previous literature. It also highlights the use of higher resolution MRI to aid in decision making regarding this rare disease.