Homonymous Hemianopsia Due to the Infarction in the Splenium of the Corpus Callosum

Abstract

The precise functions of the splenium of the corpus callosum (CC) remain unclear, and infarction of this location manifests varied clinical symptoms. We describe a rare case of right homonymous hemianopsia resulting from pure infarction in the right-side splenium of the CC. An 85-year-old man presented with right homonymous hemianopsia lasting for a week. Diffusion-weighted imaging showed a high-intensity area in the right-side splenium of the CC and did not show any other lesions in other portions of the visual pathways. Magnetic resonance angiography demonstrated anterior and posterior cerebral arteries, indicating that no large vessel occlusion existed. The visual field examination revealed right homonymous hemianopsia. The diagnosis was atherothrombotic infarction in the splenium of the CC, which resulted in right homonymous hemianopsia. Two months later, T2-weighted imaging showed a high-intensity lesion localizing the right-side splenium with shrinkage of the lesion compared to that on the acute phase, and his visual field was slightly improved. There are few reports on the splenial infarction of the CC, and this is the first case manifesting as homonymous hemianopsia, to our knowledge. Our case might help to understand complicated visual information processing involving the splenium of the CC.

Imaging findings of two patients with isolated infarction of the splenium during COVID-19

“…Within those cases, no case had been reported with homonymous hemianopsia before, while four of them had metamorphopsia. 17 In this current case report, metamorphopsia came to the forefront as a visual symptom.…”

Prediction of subjective cognitive decline after corpus callosum infarction by an interpretable machine learning-derived early warning strategy

“…The structure of CC can be divided into four classical parts in the order from front to back: rostrum, genu, body and splenium ( 54 ). Consistent with previous reports ( 5 ), we found that the incidence of ‘pure’ CC infarction was rare, while the mental disturbance and cognitive dysfunction were more prominent than ‘complex’ CC infarction.…”

“…Meanwhile, we reported for the first time that acute infarction in the splenium had a higher tendency of cognitive decline than that in the genu. As the most vulnerable area of the CC infarction, the splenium is more vulnerable to insufficient blood supply, and the splenium lesions were known to be related with cognitive disorder, aphasia, homonymous hemianopsia, alien hand syndrome and so on ( 54 ). Therefore, we believe that the splenium plays an important role in the high incidence of SCD caused by CC infarction to some extent.…”