Neurosarcoidosis of the brain, spine, orbit, and head and neck

Sarcoidosis is a noncaseating granulomatous disease of unknown etiology that can affect virtually every organ system. Neurosarcoidosis is reported in a low percentage of patients with systemic sarcoidosis, but imaging studies suggest that involvement of the brain is more common than previously realized. This report reviews the radiological features of sarcoidosis involving the brain, spine, orbit, and head and neck. There are many clinical manifestations in these locations of sarcoidosis with various correlations on neuroradiological studies. The clinical and imaging findings include basilar leptomeningeal disease associated with cranial neuropathies, pituitary dysfunction, and hypothalamic dysfunction; brain parenchymal lesions involving gray and white matter; dura-based masses; orbital lesions, particularly of the lacrimal gland; laryngeal infiltration; cervical lymphadenopathy; and spinal lesions. In some cases, the radiologist who is aware of these various manifestations may be the first to suggest the diagnosis of neurosarcoidosis.