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Last Updated: October 1, 2018

Figure 1: In this case, there are multiple scattered foci of FLAIR hyperintense signal (left) with corresponding enhancement (right) in the cerebral parenchyma. More commonly, you will see superficial pachymeningeal or leptomeningeal enhancement with enhancement and thickening of the pituitary gland, infundibulum or cranial nerves.


  • Idiopathic systemic granulomatous disease with 5% of sarcoid patients developing symptoms
  • Roughly 10% of patients with sarcoid will have neuroimaging findings, though not all will be symptomatic


  • Epithelioid granulomas without caseation or staining for infectious agents
  • Granulomas often incorporate into multinucleated giant cells and lymphocytes

Clinical Features

  • Symptoms       
    • Highly variable
    • Dependent on site of in...