Splenial Lesions of the Corpus Callosum: Disease Spectrum and MRI Findings

Abstract

The corpus callosum (CC) is the largest white matter structure in the brain, consisting of more than 200–250 million axons that provide a large connection mainly between homologous cerebral cortical areas in mirror image sites. The posterior end of the CC is the thickest part, which is called the splenium. Various diseases including congenital to acquired lesions including congenital anomalies, traumatic lesions, ischemic diseases, tumors, metabolic, toxic, degenerative, and demyelinating diseases, can involve the splenium of the CC and their clinical symptoms and signs are also variable. Therefore, knowledge of the disease entities and the imaging findings of lesions involving the splenium is valuable in clinical practice. MR imaging is useful for the detection and differential diagnosis of splenial lesions of the CC. In this study, we classify the disease entities and describe imaging findings of lesions involving the splenium of the CC based on our experiences and a review of the literature.

Acute metronidazole-induced neurotoxicity: an update on MRI findings

“…Midbrain and corpus callosum lesions, particularly the midbrain tectum and splenium of the corpus callosum, are frequently observed in MIN, and were seen in 66% and 44% of the reviewed cases, respectively. Although the midbrain tectum can be involved in entities such as Wernicke encephalopathy, and the differential diagnosis for a splenium corpus callosum lesion is extensive, 14,15 the presence of such lesions in conjunction with dentate lesions is a pattern that may be unique to metronidazole toxicity. Lesions in MIN are not restricted to these structures.…”

The splenium of the corpus callosum: embryology, anatomy, function and imaging with pathophysiological hypothesis

“…Splenial involvement in PCNSL has been described by Bruno et al in 6/7 cases with TERTp-mutated PCNSL [94]. Although these and other reports only show images with splenial PCNSL, this involvement is not specifically mentioned in the text [82,92,93,95]. The reason for this tendency is not understood, but may be related to microglia, T cell lymphocytes and perivascular spaces.…”

“…Glioblastoma multiforme (GBM) and lymphoma are known to develop in or extend into the splenium or the remainder of the CC [82]. We would also like to add the diffuse infiltrating glioma (previously known as gliomatosis cerebri) to this list.…”

Reversible lesion in the splenium of the corpus callosum

“…In addition to infection, MERS has also been reported to be associated with epilepsy and the use of antiepileptic drugs (Maeda et al, 2003;Mirsattari, Lee, Jones, & Blume, 2003). Extant literature has reported the other potential causes including substance withdrawal, metabolic disturbance, drug-related toxicity, malignancies, cerebrovascular diseases, traumatic brain injury, status migrainosus, and high-altitude disease (altitude sickness) (Al Brashdi & Albayram, 2015;Bin & Lee, 2011;Garcia-Monco et al, 2011;Kallenberg et al, 2007;Kim & Gean, 2011;Maeda et al, 2006;Park et al, 2017;Renard, Bonafe, & Heroum, 2007;Samanta, 2015;Starkey, Kobayashi, Numaguchi, & Moritani, 2017;Takanashi et al, 2009;Takayama, Kobayashi, Sugishita, & Mihara, 2000;Tha et al, 2002;Yamaguchi et al, 2019). A listing is provided in Table identified the etiologies for 30 cases including cerebral infarction (50%), trauma (13.3%), tumor (10%), alcohol abuse (6.7%), seizure (6.7%), heat stroke (3.3%), multiple sclerosis (3.3%), drug intoxication (3.3%), and panhypopituitarism (3.3%).…”