Acute necrosis of the corpus callosum

•Marchiafava-Bignami disease is a rare disorder associated with chronic alcohol consumption.•Clinicians should keep a high level of suspicion since clinical presentation is highly variable.•Diagnosis relies on MRI findings correlated with a context of alcohol abuse and malnutrition.•Brain MRI usually shows cytotoxic lesions of the corpus callosum.•Early treatment with intravenous thiamine is associated with a better prognosis.