Reversible Splenial Lesion in the Corpus Callosum on MRI after Ingestion of a Herbicide Containing Glufosinate Ammonium: A Case Report

Kim, T.Y.; Park, Dong Woo; Park, Chung Ki; Lee, Seung Ro

doi:10.3348/jksr.2014.70.6.399

“…[ 1 2 3 5 8 ] Furthermore, several reports of GLA-induced SCC lesions presented that there were no neurological complications other than reversible memory impairment. [ 6 9 ] However, our patient developed not only memory impairment, but also prolonged overall cognitive dysfunction. These are rare clinical manifestations that are distinct from previous reports.…”

Section: Discussionmentioning

confidence: 75%

“…[ 3 5 ] Surfactants such as polyoxyethylene alkyl ether sulfate can increase the permeability of the blood–brain barrier, thereby enhancing GLA's neurotoxicity. [ 6 ] A recent study reported decreased glucose metabolism in the lower frontal and temporal lobes on F-18 fluorodeoxyglucose positron emission tomography scan of patients with GLA poisoning. They suggested that glucose hypometabolism could lead to long-lasting memory impairment regardless of structural brain lesions.…”

Section: Discussionmentioning

confidence: 99%

Prolonged cognitive dysfunction in patient with splenial lesion of the corpus callosum caused by glufosinate ammonium poisoning

Lee

¹

,

Kang

²

2021

Turk J Emerg Med

2

0

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Glufosinate ammonium (GLA) is widely used as a commercial herbicide in many countries. Neurotoxicity of GLA has been associated with serious neurological complications such as loss of consciousness, convulsions, and memory impairment. Late-onset memory impairment due to GLA-induced hippocampal lesions is the most distinct clinical feature in GLA poisoning. However, the lesion of the splenium of the corpus callosum (SCC) is a rare condition in GLA poisoning, so the clinical features are not well known. We report the case of a 57-year-old male patient who developed SCC damage after GLA poisoning. The patient had various late-onset neurotoxic symptoms, including prolonged overall cognitive dysfunction and psychosis-like symptoms. Emergency physicians should be aware that GLA-induced SCC lesions may be associated with various late-onset neurotoxic symptoms.

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Zytotoxische Läsionen des Corpus callosum mit eingeschränkter Diffusion

Starkey¹,

Kobayashi²,

Numaguchi³

et al. 2019

Neuroradiol Scan

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Cytotoxic lesions of the corpus callosum (CLOCCs) are secondary lesions associated with various entities. CLOCCs have been found in association with drug therapy, malignancy, infection, subarachnoid hemorrhage, metabolic disorders, trauma, and other entities. In all of these conditions, cell-cytokine interactions lead to markedly increased levels of cytokines and extracellular glutamate. Ultimately, this cascade can lead to dysfunction of the callosal neurons and microglia. Cytotoxic edema develops as water becomes trapped in these cells. On diffusion-weighted magnetic resonance (MR) images, CLOCCs manifest as areas of low diffusion. CLOCCs lack enhancement on contrast material-enhanced images, tend to be midline, and are relatively symmetric. The involvement of the corpus callosum typically shows one of three patterns: (a) a small round or oval lesion located in the center of the splenium, (b) a lesion centered in the splenium but extending through the callosal fibers laterally into the adjacent white matter, or (c) a lesion centered posteriorly but extending into the anterior corpus callosum. CLOCCs are frequently but not invariably reversible. Their pathologic mechanisms are discussed, the typical MR imaging findings are described, and typical cases of CLOCCs are presented. Although CLOCCs are nonspecific with regard to the underlying cause, additional imaging findings and the clinical findings can aid in making a specific diagnosis. Radiologists should be familiar with the imaging appearance of CLOCCs to avoid a misdiagnosis of ischemia. When CLOCCs are found, the underlying cause of the lesion should be sought and addressed.

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Cytotoxic Lesions of the Corpus Callosum That Show Restricted Diffusion: Mechanisms, Causes, and Manifestations

Starkey

¹

,

Kobayashi

²

,

Numaguchi

³

et al. 2017

View full text Add to dashboard Cite

Cytotoxic lesions of the corpus callosum (CLOCCs) are secondary lesions associated with various entities. CLOCCs have been found in association with drug therapy, malignancy, infection, subarachnoid hemorrhage, metabolic disorders, trauma, and other entities. In all of these conditions, cell-cytokine interactions lead to markedly increased levels of cytokines and extracellular glutamate. Ultimately, this cascade can lead to dysfunction of the callosal neurons and microglia. Cytotoxic edema develops as water becomes trapped in these cells. On diffusion-weighted magnetic resonance (MR) images, CLOCCs manifest as areas of low diffusion. CLOCCs lack enhancement on contrast material-enhanced images, tend to be midline, and are relatively symmetric. The involvement of the corpus callosum typically shows one of three patterns: (a) a small round or oval lesion located in the center of the splenium, (b) a lesion centered in the splenium but extending through the callosal fibers laterally into the adjacent white matter, or (c) a lesion centered posteriorly but extending into the anterior corpus callosum. CLOCCs are frequently but not invariably reversible. Their pathologic mechanisms are discussed, the typical MR imaging findings are described, and typical cases of CLOCCs are presented. Although CLOCCs are nonspecific with regard to the underlying cause, additional imaging findings and the clinical findings can aid in making a specific diagnosis. Radiologists should be familiar with the imaging appearance of CLOCCs to avoid a misdiagnosis of ischemia. When CLOCCs are found, the underlying cause of the lesion should be sought and addressed. RSNA, 2017 An earlier incorrect version of this article appeared online. This article was corrected on February 13, 2017.

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Reversible Splenial Lesion in the Corpus Callosum on MRI after Ingestion of a Herbicide Containing Glufosinate Ammonium: A Case Report

Cited by 4 publications

References 9 publications

Prolonged cognitive dysfunction in patient with splenial lesion of the corpus callosum caused by glufosinate ammonium poisoning

Prolonged cognitive dysfunction in patient with splenial lesion of the corpus callosum caused by glufosinate ammonium poisoning

Zytotoxische Läsionen des Corpus callosum mit eingeschränkter Diffusion

Cytotoxic Lesions of the Corpus Callosum That Show Restricted Diffusion: Mechanisms, Causes, and Manifestations

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