Splenial and White Matter Lesions Showing Transiently-reduced Diffusion in Mild Encephalopathy Monitored with MR Spectroscopy and Imaging

Ueda, Fumiaki; Yoshie, Yuichi; Aburano, Hiroyuki; Hashimoto, Masahiro; Matsui, Osamu; Gabata, Toshifumi

doi:10.2463/mrms.2014-0011

Cited by 5 publications

(5 citation statements)

References 11 publications

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“…Normal NAA and no significant peaks of lip and Glx suggested that normal neuronal integrity was preserved, without evidence of irreversible neuro-axonal damage [23,25,]. These results are consistent with the limited available MRS studies of transient SCC lesions, suggesting that a reversible intramyelinic citotoxic edema could represent the main pathophysiologic mechanism 355 [19,[46][47][48].…”

Section: Discussionsupporting

confidence: 59%

Treatment-related transient splenial lesion of the Corpus Callosum in patients with neuropsychiatric disorders: a literature overview with a case report

Cirnigliaro

Bernardo

Caricasole

et al. 2020

Expert Opinion on Drug Safety

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Q1Introduction: Transient-localized © lesions of the splenium of the corpus callosum (SCC) have been described in various clinical conditions, some of them being attributed to the withdrawal of psychotropic drugs. The pathophysiology of the lesion likely reflects cytotoxic edema and reversible demyelination.Areas covered: The present article aimed at reviewing cases of transient SCC lesion exclusively related to changes in pharmacological treatment. It also reports the original case of a psychotic patient receiving a complex psychopharmacological therapy who developed a transient SCC lesion investigated by magnetic resonance imaging (MRI), magnetic resonance spectroscopy (MRS), © and pharmacogenetic profiling. Expert opinion: To date, only one review on the subject has been published, analyzing 22 cases of transient SCC lesion arising in epileptic patients on antiepileptic therapy. It hypothesized that the nature of the lesion is a cytotoxic edema and the cases described in the subsequent 14 years seem to support this hypothesis. The authors reported the case of an Italian-Egyptian patient who developed a transient SCC lesion after the rapid withdrawal of Carbamazepine and Lurasidone. The lesion completely disappeared from the MRI performed after 1 month © . Patient's ethnic group and its specific pharmacogenetic profile were considered as possible causes of altered drug metabolism and, likely, of the SCC lesion. Q2 ARTICLE HISTORY

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Section: Discussionsupporting

confidence: 59%

Treatment-related transient splenial lesion of the Corpus Callosum in patients with neuropsychiatric disorders: a literature overview with a case report

Cirnigliaro

Bernardo

Caricasole

et al. 2020

Expert Opinion on Drug Safety

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“…On diffusion tensor imaging, only slight change on diffusion anisotropy has been demonstrated . On MRS, normal/near normal spectrum with normal N ‐acetyl‐aspartate (NAA) further supports transient intramyelinic edema over neuroaxonal damage or severe demyelination . It is unclear why there is increased vulnerability of the splenium of the CC, and there is no definite difference in fiber composition of the splenium when compared with the remainder of the CC .…”

Section: Reversible Splenial Lesionsmentioning

confidence: 99%

Lesions in the Splenium of the Corpus Callosum on MRI in Children: A Review

Kontzialis

Soares

Huisman

2017

Journal of Neuroimaging

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A wide variety of conditions may involve the splenium of the corpus callosum on magnetic resonance imaging in children. A single cause may present with different patterns of splenial involvement, and multiple diseases may have similar imaging findings. Keeping this limitation in mind, the goal of this text is to assist in the diagnostic process of pediatric neurological diseases that are characterized by prominent involvement of the splenium of the corpus callosum on imaging. The various pathologies will be reviewed and categorized based on etiology, reversibility, and pattern of additional or associated findings. Transient splenial lesions in children are an uncommon radiologic finding of unknown etiology in a long list of conditions that may present with altered consciousness, and it usually carries a favorable prognosis. The discussion continues with the presentation of diseases inflicting irreversible damage on the splenium. Familiarity with the various causes implicated in splenial injury may assist in the formulation of differential diagnosis in the appropriate clinical setting using an easily recognizable imaging finding.

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“…Of the persisting or residual cases, 22 were in adults and five in children. Rarely, CLOCC persisted without major changes (number of patients = 2; 1%) until their follow-up at 1 month [ 2 ] and 3 months [ 11 ], respectively.…”

Section: Resultsmentioning

confidence: 99%

“…One hundred twenty-five publications included children only, comprising a total of 937 children. Their median age was 5.1 years (IQR [4][5][6][7][8][9][10][11][12].…”

Section: Eligible Publications and General Study Characteristicsmentioning

confidence: 99%

Cytotoxic lesions of the corpus callosum: a systematic review

Moors,

Nakhostin,

Ilchenko

et al. 2023

Eur Radiol

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Objectives Cytotoxic lesions of the corpus callosum (CLOCC) are a common magnetic resonance imaging (MRI) finding associated with various systemic diseases including COVID-19. Although an increasing number of such cases is reported in the literature, there is a lack of systematic evidence summarizing the etiology and neuroimaging findings of these lesions. Thus, the aim of this systematic review was to synthesize the applied nomenclature, neuroimaging and clinical features, and differential diagnoses as well as associated disease entities of CLOCC. Materials and methods A comprehensive literature search in three biomedical databases identified 441 references, out of which 324 were eligible for a narrative summary including a total of 1353 patients. Results Our PRISMA-conform systematic review identifies a broad panel of disease entities which are associated with CLOCC, among them toxic/drug-treatment-associated, infectious (viral, bacterial), vascular, metabolic, traumatic, and neoplastic entities in both adult and pediatric individuals. On MRI, CLOCC show typical high T2 signal, low T1 signal, restricted diffusion, and lack of contrast enhancement. The majority of the lesions were reversible within the follow-up period (median follow-up 3 weeks). Interestingly, even though CLOCC were mostly associated with symptoms of the underlying disease, in exceptional cases, CLOCC were associated with callosal neurological symptoms. Of note, employed nomenclature for CLOCC was highly inconsistent. Conclusions Our study provides high-level evidence for clinical and imaging features of CLOCC as well as associated disease entities. Clinical relevance statement Our study provides high-level evidence on MRI features of CLOCC as well as a comprehensive list of disease entities potentially associated with CLOCC. Together, this will facilitate rigorous diagnostic workup of suspected CLOCC cases. Key Points • Cytotoxic lesions of the corpus callosum (CLOCC) are a frequent MRI feature associated with various systemic diseases. • Cytotoxic lesions of the corpus callosum show a highly homogenous MRI presentation and temporal dynamics. • This comprehensive overview will benefit (neuro)radiologists during diagnostic workup.

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Splenial and White Matter Lesions Showing Transiently-reduced Diffusion in Mild Encephalopathy Monitored with MR Spectroscopy and Imaging

Cited by 5 publications

References 11 publications

Treatment-related transient splenial lesion of the Corpus Callosum in patients with neuropsychiatric disorders: a literature overview with a case report

Treatment-related transient splenial lesion of the Corpus Callosum in patients with neuropsychiatric disorders: a literature overview with a case report

Lesions in the Splenium of the Corpus Callosum on MRI in Children: A Review

Cytotoxic lesions of the corpus callosum: a systematic review

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