Cranial Computed Tomography Findings in Patients with Eating Disorders

Abstract

Cranial computed tomography (CT) examinations have confirmed former postmortem and pneumencephalographic observations that patients suffering from anorexia nervosa display morphological brain alterations characterized by an enlargement of the external CSF spaces (i.e., insular cisterns, interhemispheric fissure, cortical and cerebellar sulci) and by a dilatation of the ventricles (Artmann et al. 1985; Enzmann and Lane 1977; Gagel 1953; Heidrich and Schmidt-Matthias 1961; Heinz et al. 1977; Kohlmeyer et al. 1983; Lankenau et al. 1985; Nussbaum et al. 1980; Sein et al. 1981). The technique of CT has also made it possible to follow up patients with those structural changes and to demonstrate that in some cases the enlarged CSF spaces decrease in size after weight gain (Artmann et al. 1985; Heinz et al. 1977; Kohlmeyer et al. 1983; Sein et al. 1981). A number of pathogenetic mechanisms have been considered to be responsible for the morphological changes, for example a shift of fluid out of intravascular spaces into CSF spaces as a consequence of an altered permeability of the blood vessels (Heidrich and Schmidt-Matthias 1961), a diminished blood flow, malnutrition-induced changes of brain protein synthesis, or alteration in CSF pressure dynamics (Artmann et al. 1985; Lankenau et al. 1985). However, at present the etiology of the enlarged CSF spaces in patients with anorexia nervosa is still unclear.