[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-435870-105":59,"doc-detail-435870-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","krabbe-disease-a-differential-cause-of-the-hyperdense-boomerang-sign","Krabbe disease: a differential cause of the hyperdense boomerang sign","","Case description of a 1.5-year-old girl with developmental regression, spastic tetraparesis, and fever. CT demonstrated hyperdense findings, while MRI showed restricted diffusion in the splenium of the corpus callosum, producing the boomerang sign. Follow-up revealed bilateral, symmetrical T2/FLAIR hyperintense white-matter lesions with tiger/leopard-skin pattern, plus brainstem, corticospinal tract, and dentate nucleus involvement. Cranial nerve and spinal root enhancement was also present; genetic testing confirmed the GALC c.884A>T variant.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/krabbe-disease-a-differential-cause-of-the-hyperdense-boomerang-sign/435870/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/krabbe-disease-a-differential-cause-of-the-hyperdense-boomerang-sign/435870.png","ImageObject",300,407,{"name":92,"@type":93},"Himbo","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-06","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What imaging features suggest Krabbe disease in this article?","Question",{"text":112,"@type":113},"CT shows hyperdensity and MRI shows restricted diffusion in the splenium of the corpus callosum, forming the boomerang sign. Follow-up MRI also shows bilateral symmetrical T2/FLAIR hyperintense lesions in cerebral white matter with a tiger/leopard-skin pattern.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Which additional brain and nerve structures were reported as involved?",{"text":117,"@type":113},"The follow-up described involvement of the brainstem, corticospinal tracts, and dentate nuclei. It also reported thickening and enhancement of cranial nerves (III, V, VI, VII, VIII) and diffuse thickening and enhancement of spinal roots.",{"name":119,"@type":110,"acceptedAnswer":120},"How was Krabbe disease confirmed?",{"text":121,"@type":113},"Genetic testing confirmed Krabbe disease by identifying the GALC gene variant c.884A>T in heterozygosity.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},435870,1790763553,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":14,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":24,"preview_page_count":4},687197100911,"https://ap-avatar.wpscdn.com/avatar/a000239b6f1da00475?x-image-process=image/resize,m_fixed,w_180,h_180&k=1785132997149421697","Article published online: 2025-08-04  \nNeuroimaging 1  \nKrabbe disease: a differential cause of the hyperdense boomerang sign  \nLuis Alcides Quevedo Canete 1 Sérgio Ferreira Alves Júnior2 Ângelo Dante de Carvalho Côrrea 1 Nina Ventura2  \n1 Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro RJ, Brazil.  \n2 Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.  \nAddress for correspondence Luis Alcides Quevedo Canete (email: [poloquevedo@gmail.com](poloquevedo@gmail.com))  \nArq. Neuro-Psiquiatr. 2025;83(12):s00451809997 .  \nA 1.5-year-old female child presented with regression of developmental milestones, spastic tetraparesis, and fever. Computed tomography (CT) scans showed hyperdensity, and magnetic resonance imaging (MRI) scans revealed restricted diffusion in the splenium of the corpus callosum, characterizing the boomerang sign ( ►Figure 1). On the follow-up examination, bilateral and symmetrical T2 and fluid-attenuated inversion recovery (FLAIR) hyperintense lesions were observed in the cerebral white matter, predominantly in the parieto-occipital regions, presenting a tiger-or leopard-skin pattern, as well as involvement of the brainstem, corticospinal tracts, and dentate nuclei ( ►Figure 2 A–C). Additionally, bilateral thickening and enhancement of the cranial nerves were noted, most prominently in the cisternal portions ofthe III, V, and VI pairs, and in  \nthe intracanalicular portions of the VII and VIII pairs. Diffuse thickening and enhancement of the spinal roots were also observed ( ►Figure 2 D–G). Krabbe disease was confirmed through genetic testing, which identified the c.884A>T variant in heterozygosity in the GALC gene. In clinical presentations featuring hyperdense lesions on CT and restricted diffusion on MRI in the corpus callosum (splenium), Krabbe disease should be considered.1–4  \nAuthors’ Contributions  \nConceptualization: LAQC, SFAJ, ADCC, NVW; Data curation: LAQC, SFAJ, ADCC; Investigation: LAQC, SFAJ, ADCC; Writing – original draft: LAQC, SFAJ, ADCC; Writing – review & editing: NVW.  \nFigure 1 Brain computed tomography (CT) and magnetic resonance imaging (MRI) scans revealing hyperdensity (A,B) and restricted diffusion (C,D) in the splenium of the corpus callosum.  \nreceived  \nMarch 10, 2025  \nreceived in its final form May 05, 2025  \naccepted May 7, 2025  \nDOI [https://doi.org/](https://doi.org/)[ ](https://doi.org/)10.1055/s-0045-1809997 . ISSN 0004-282X.  \nEditor-in-Chief: Hélio A. G. Teive.  \nAssociate Editor: Leandro Tavares Lucato.  \n© 2025 . The Author(s) .  \nThis is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit ([https://creativecommons.org/licenses/by/4.0/](https://creativecommons.org/licenses/by/4.0/))  \nThieme Revinter Publicações Ltda. , Rua Rego Freitas, 175, loja 1, República, São Paulo, SP, CEP 01220-010, Brazil  \n2 Krabbe disease Canete et al.  \nFigure 2 Brain MRI scans revealing bilateral and symmetrical T2 and fluid-attenuated inversion recovery (FLAIR) hyperintense lesions in the white matter of the cerebral hemispheres, predominantly in the parieto-occipital regions, displaying a tiger-like or leopard-skin pattern (white arrows in A and B) . Involvement of the brainstem and corticospinal tracts (white arrows in C) was observed, along with thickening and enhancement of the trigeminal nerves (white arrowhead in D) and spinal roots (white arrowheads in E , F, and G) .  \nConflict of Interest  \nThe authors have no conflict of interest to declare.  \nData Availability Statement  \nThe data supporting the conclusions of the present study are available in our institution’s database.  \nReferences  \n1 Muthusamy K, Sudhakar SV, Thomas M, Yoganathan S, Christudass CS, Chandran M, et al. Revisiting magnetic resonance imaging pattern of Krabbe disease-Lessons from an Indian cohort. J Clin Imaging Sci 2019;9:25. Doi: ","cbCaido04dFr0DK6","https://ap.wps.com/l/cbCaido04dFr0DK6","pdf",932762,"English","# Neuroimaging 1\n## Case presentation and imaging findings\n## Genetic confirmation and clinical implication","[{\"question\":\"What imaging features suggest Krabbe disease in this article?\",\"answer\":\"CT shows hyperdensity and MRI shows restricted diffusion in the splenium of the corpus callosum, forming the boomerang sign. Follow-up MRI also shows bilateral symmetrical T2/FLAIR hyperintense lesions in cerebral white matter with a tiger/leopard-skin pattern.\"},{\"question\":\"Which additional brain and nerve structures were reported as involved?\",\"answer\":\"The follow-up described involvement of the brainstem, corticospinal tracts, and dentate nuclei. It also reported thickening and enhancement of cranial nerves (III, V, VI, VII, VIII) and diffuse thickening and enhancement of spinal roots.\"},{\"question\":\"How was Krabbe disease confirmed?\",\"answer\":\"Genetic testing confirmed Krabbe disease by identifying the GALC gene variant c.884A\\u003eT in heterozygosity.\"}]","Krabbe disease: a differential cause of the hyperdense boomerang sign | PDF",1790675668]