Infarction of the corpus callosum: computed tomography and magnetic resonance imaging

Chrysikopoulos, H; Andreou, John; Roussakis, Arkadios; Pappas, John N.

doi:10.1016/s0720-048x(96)01155-2

Cited by 98 publications

(82 citation statements)

References 16 publications

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“…1,3 Considering that our case patient 01 was infected, this could have been one of the mechanisms that can caused the hypodense in the CC, as suggest Yuan et al 3 Also, the literature mentions some cases attributed to antiepileptic drug toxicity. 1,7,8 In consequence the manifestations of LHECC are variable; and is difficult to evaluate because the large number of comorbidities. Also these type of lesions can be found in asymptomatic individuals.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][6][7][8][9][10] Another conditions in our patients; was the many comorbidities associated, with a neurological examination without neurological focus that would to delay the diagnosis. In the cases 01 and 03, there was an acute renal disease, and the needs of hemodialysis in one of them; this finding, could presume if this type of lesions would be secondary to uremia.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies 2,4,9 show that these lesions are more frequent than expected. Chrysikopoulos 8 performed a retrospective study of 352 patients with neuroimaging; and did found 28 cases with lesions in the corpus callosum, in greater proportion in the splenium. Pekala, 4 nevertheless questions why the splenium callosum lesions are being reported in more frequency nowadays and not before despite the neuroimaging are available years ago?.…”

Section: Discussionmentioning

confidence: 99%

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Clinical spectrum of callosum corpus splenium lesions: subdiagnostics of a common entity

Cañas¹

2018

JNSK

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Clinical spectrum of callosum corpus splenium lesions: subdiagnostics of a common entity Submit Manuscript | http://medcraveonline.com Abbreviations: CC, callosum corpus; MERS, mild encephalitis/encephalopathy with a reversible isolated splenium callosum corpus lesion; LHECC, hypodense lesion in the splenius of the corpus callosum; BBB, blood-brain barrier; NU, neurology´s unit; ED, emergency department; CT, computer tomography; MRI, magnetic resonance imaging; HD, hemodialysis ; ECG, electrocardiogram; ECHOC, echocardiogram; LP, lumbar punction; EEG, electroencephalogram IntroductionThe callosum corpus (CC) is the largest white matter commissure of the brain that communicates both hemispheres.1 Anatomically, can be divided in 3 portions: anterior, middle and posterior; two first that depends of anterior circulation; and the splenius of the corpus callosum of posterior respectively. 1 The most frequent causes of injury of CC are cerebrovascular stroke, cranial brain trauma, central nervous system infections, alcohol, epilepsy, multiple sclerosis and MERS syndrome (mild encephalitis/ encephalopathy with a reversible isolated splenium callosum corpus lesion).2,3 Pekala et al. 4 suggest to include patients who are or have undergone oncologic radiotherapy of the head and neck. 4 The MERS's clinic is variable. Confusion or alteration of consciousness is the most frequent clinical sign.2 Another study considers fever and headache as a predominant symptomatology. 3 Both mention dysarthria, seizures, hemiparesis and associated ataxias. And recently, athetosis was described by one of the authors. 5It´s important to consider that in elderly patients, it is possible to find a silent hypodense lesion in the splenius of the corpus callosum (LHECC) as radiological findings; as well it has been mentioned in children; probably directly related to the inmaturity and involution of the central nervous system related to a fragility of the bloodbrain barrier (BBB). 4 We communicate 3 patients hospitalized in our Neurology Unit (NU) between July and October 2017, due to confusional syndrome in two of them, and seizures in the remainder; and in which, neuroimaging studies showed a unique hypodensity in the splenius of the corpus callosum. Case presentation Case 1Male, of 65 years old, with diabetes mellitus, and hypertension both with poor treatment; suspended smoking and occasional alcohol consumption who has a emergency department (ED) consultation by 10 days of fluctuating confusional syndrome associated with headache, psychomotor agitation and gait instability. Is initially evaluated in the ED, with blood pressure level (231/122 mmhg), hemoglucotest (448 mg/dl); and physical examination that evidenced a arousal patient, time and place disorientated; and without focal neurological deficits. Laboratory tests showed a serum creatinine level in 3.29, blood urea nitrogen 44, glycemia 393, Ph 7.33, HCO 3 19, Na 142, K 4.3. Computer tomography (CT) was informed as a microangiopathy of the supratentorial white matter and a left thalamic s...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Clinical spectrum of callosum corpus splenium lesions: subdiagnostics of a common entity

Cañas¹

2018

JNSK

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“…Infarcts of the corpus callosum are uncommon and are attributed to a rich blood supply from three main arterial systems: The anterior communicating artery, the pericallosal artery and the posterior pericallosal artery [1,2]. The pericallosal branches of the Anterior Cerebral Artery (ACA) supply the major portion of the body of the CC.…”

Section: Discussionmentioning

confidence: 99%

“…The subcallosal artery provides blood supply to the medial portions of the rostrum and genu of the CC. The median callosal branches supply the rostrum, genu, and body of the CC and medial aspect of the frontal and parietal lobes [1,10]. The perpendicular origins of the pericallosal vessels make it difficult for the emboli to enter these vessels.…”

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Midline Watershed: Unusual Border-Zone Infarct of the Corpus Callosum

Ambady¹,

Rao³

2014

J Clin Case Rep

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Case Report46-year-old man with diabetes, hypertension, hypercholesterolemia, and end stage renal disease presented with acute confusion. His BP was noted to be 60/28 mm Hg. He opened his eyes to verbal commands. Right pupil was 5 mm and the left pupil 4.5 mm, both reactive to light. Exotropia and hypotropia of the right eye, and roving eye movements were noted. He withdrew all rxtremities to pain. DTR's were noted as 3/4 in the left upper and 2/4 in the right upper limbs, and absent in the lower limbs. Babinski's sign was absent. MRI of the brain showed hyper intensity involving the entire corpus callosum on DWI (Figures 1 and 2). MRA showed stenosis of the proximal A1 segment of the right ACA at its bifurcation with a hypoplastic right PCA (Figure 3). The patient subsequently had a pulseless electrical activity code and died. DiscussionInfarcts of the corpus callosum are uncommon and are attributed to a rich blood supply from three main arterial systems: The anterior communicating artery, the pericallosal artery and the posterior pericallosal artery [1,2]. The pericallosal branches of the Anterior Cerebral Artery (ACA) supply the major portion of the body of the CC. Perforating branches of the ACA supplies the rostrum and genu [3]. The pericallosal branch may reach as far back as the foramen of Monro. It gives rise to four branches: the callosal, cingulo callosal, long callosal, and recurrent callosal arteries [4][5]. There are 3 to 23 cingulo callosal arteries per hemisphere that supply anterior parts of the corpus callosum; and form abundant anastomoses.The splenium of the CC is supplied by the posteror callosal branch of the Posterior cerebral artery (PCA) or the splenic artery. They take off perpendicularly from the PCA [1,6,7]. An accessory posterior pericallosal artery has been described [6]. Anastomosis of the ACA and PCA branches occurs at the tip of the splenium in 75% to 100% of the cases [7,8].The anterior communicating artery also supplies the CC [3,9]. The subcallosal artery provides blood supply to the medial portions of the rostrum and genu of the CC. The median callosal branches supply the rostrum, genu, and body of the CC and medial aspect of the frontal and parietal lobes [1,10]. The perpendicular origins of the pericallosal vessels make it difficult for the emboli to enter these vessels. Unusual features include arteriole-venule pairs, perivascular fibrous alae, and recurrent companion arterioles, providing resistance to atherosclerosis [10]. Pericallosal pial plexus also adds stability [4,[11][12][13]. Chrysikopoulos et al. described only three diffuse lesions involving the genu and body of the CC [1]. The splenium was the most common site followed by the body and genu. This can be explained by the fact that the final anastomosis between the ACA and PCA occurs at the tip AbstractIschemic lesions involving the Corpus Callosum (CC) are rare. Symptoms are nonspecific and clinical findings vary depending on the site and size of the lesions. We describe a rare case of watershed infarct involvin...

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Multiple cysts of the corpus callosum and psychomotor delay in a patient with a 3.1 Mb 15q24.1q24.2 interstitial deletion identified by array‐CGH

Masurel‐Paulet

Callier²,

Thauvin‐Robinet

et al. 2009

American J of Med Genetics Pt A

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We describe a 46-month-old child presenting with developmental delay, mild facial dysmorphism, micropenis, strabismus and striking multiple cysts of the corpus callosum who was found to have a de novo interstitial 3.1 Mb 15q24.1q24.2 microdeletion using a 244 K microarray-based comparative genomic hybridization (array-CGH). The cystic lesions were located in the anterior half of the corpus callosum and did not take up gadolinium contrast. There was no other brain abnormality, and the gyral pattern and myelination were normal. There was no history of infectious disease or vascular injury and a metabolic disease was ruled out. Such cystic lesions of the corpus callosum are exceptional in the pediatric literature. Although these brain abnormalities have not been described in other reports with 15q24 microdeletion, we believe that they might be related to the cytogenetic abnormality since the work-up for other causes was negative. We suggest that a chromosomal rearrangement should be ruled out when such corpus callosum lesions are identified.

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Infarction of the corpus callosum: computed tomography and magnetic resonance imaging

Cited by 98 publications

References 16 publications

Clinical spectrum of callosum corpus splenium lesions: subdiagnostics of a common entity

Clinical spectrum of callosum corpus splenium lesions: subdiagnostics of a common entity

Midline Watershed: Unusual Border-Zone Infarct of the Corpus Callosum

Multiple cysts of the corpus callosum and psychomotor delay in a patient with a 3.1 Mb 15q24.1q24.2 interstitial deletion identified by array‐CGH

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