Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Neuroradiology
Published in: Neuroradiology 10/2006

01-10-2006 | Diagnostic Neuroradiology

Focal transient lesion in the splenium of the corpus callosum in three non-epileptic patients

Authors: Antônio José da Rocha, Fabiano Reis, Hugo Pereira Pinto Gama, Carlos Jorge da Silva, Flávio Túlio Braga, Antônio Carlos Martins Maia Júnior, Fernando Cendes

Published in: Neuroradiology | Issue 10/2006

Login to get access

Abstract

Introduction

We analyzed the imaging features of transient focal lesions in the splenium of the corpus callosum (SCC) in non-epileptic patients receiving antiepileptic drugs (AEDs).

Methods

We identified signal abnormalities in the SCC in three non-epileptic patients, all of them receiving AEDs. We examined two of these patients with multiplanar magnetic resonance (MR) imaging using 1.0-T equipment including fluid-attenuated inversion recovery (FLAIR), T2-weighted (TSE) and T1-weighted (SE) sequences before and after injection of contrast agent. The third patient was studied using 1.5-T equipment with the same sequences. Additionally, a T1 SE sequence with a magnetization transfer contrast pulse off resonance (T1 SE/MTC), diffusion-weighted imaging (EPI-DWI) and apparent diffusion coefficient (ADC) maps were obtained.

Results

We observed an identical pattern of imaging abnormalities in all patients characterized by round lesions, hyperintense on FLAIR and hypointense on T1 SE images, located in the central portion of the SCC. One lesion showed homogeneous gadolinium enhancement and perilesional vasogenic edema. This particular lesion showed restricted diffusion confirmed on the ADC map. This pattern was considered consistent with focal demyelination. Follow-up MR examinations showed complete disappearance or a clear reduction in lesion size. All patients had been treated with AEDs, but they did not show any clinical signs of toxicity, interhemispheric symptoms, or abnormal neurological findings (including seizures).

Conclusion

We believe that our MR findings might be interpreted as transient lesions related to AED toxicity. They presumably resulted from focal demyelination in the central portion of the SCC.
Literature
1.
Doherty MJ, Jayadev S, Watson NF, et al (2005) Clinical implications of splenium magnetic resonance imaging signal changes. Arch Neurol 62(3):433–437PubMedCrossRef
2.
Tada H, Takanashi J, Barkovich AJ, et al (2004) Clinically mild encephalitis/encephalopathy with a reversible splenial lesion. Neurology 63(10):1854–1858PubMed
3.
Takanashi J, Barkovich AJ, Yamaguchi K, et al (2004) Influenza-associated encephalitis/encephalopathy with a reversible lesion in the splenium of the corpus callosum: a case report and literature review. AJNR Am J Neuroradiol 25(5):798–802PubMed
4.
Kobata R, Tsukahara H, Nakai A, et al (2002) Transient MR signal changes in the splenium of the corpus callosum in rotavirus encephalopathy: value of diffusion-weighted imaging. J Comput Assist Tomogr 26(5):825–828PubMedCrossRef
5.
Maeda M, Shiroyama T, Tsukahara H, et al (2003) Transient splenial lesion of the corpus callosum associated with antiepileptic drugs: evaluation by diffusion-weighted MR imaging. Eur Radiol 13(8):1902–1906PubMedCrossRef
6.
Prilipko O, Delavelle J, Lazeyras F, et al (2005) Reversible cytotoxic edema in the splenium of the corpus callosum related to antiepileptic treatment: report of two cases and literature review. Epilepsia 10:1633–1636CrossRef
7.
Chason D, et al (1996) Transient splenial edema in epilepsy: MR imaging evaluation. Presented at the Annual Meeting of the American Society of neuroradiology; 21–27 June, Seattle, WA
8.
Kim SS, Chang KH, Kim ST, et al (1999) Focal lesion in the splenium of the corpus callosum in epileptic patients: antiepileptic drug toxicity? AJNR Am J Neuroradiol 20(1):125–129PubMed
9.
Oster J, Doherty C, Grant PE, et al (2003) Diffusion-weighted imaging abnormalities in the splenium after seizures. Epilepsia 44(6):852–854PubMedCrossRef
10.
Tennison M (1999) Focal lesion in the splenium of the corpus callosum in epileptic patients: antiepileptic drug toxicity? AJNR Am J Neuroradiol 20(1):131–132PubMed
11.
Polster T, Hoppe M, Ebner A (2001) Transient lesion in the splenium of the corpus callosum: three further cases in epileptic patients and a pathophysiological hypothesis. J Neurol Neurosurg Psychiatry 70(4):459–463PubMedCrossRef
12.
Hakyemez B, Erdogan C, Yildirim N, et al (2005) Transient splenial lesion of corpus callosum associated with antiepileptic drug: conventional and diffusion-weighted magnetic resonance images. Acta Radiol 7:734–736CrossRef
13.
Takanashi J, Barkovich AJ, Shiihara T, et al (2006) Widening spectrum of a reversible splenial lesion with transiently reduced diffusion. AJNR Am J Neuroradiol 27:836–838PubMed
14.
Henry TR, Drury I, Brunberg JA, et al (1994) Focal cerebral magnetic resonance changes associated with partial status epilepticus. Epilepsia 35(1):35–41PubMedCrossRef
15.
Mirsattari SM, Lee DH, Jones MW, et al (2003) Transient lesion in the splenium of the corpus callosum in an epileptic patient. Neurology 60(11):1838–1841PubMed
16.
17.
Butler WH, Ford GP, Newberne JW (1987) A study of the effects of vigabatrin on the central nervous system and retina of Sprague Dawley and Lister-Hooded rats. Toxicol Pathol 15(2):143–148PubMedCrossRef
18.
Mehta R, Pike G, Enzmann D (1996) Measure of magnetization transfer in multiple sclerosis demyelinating plaques, white matter ischemic lesions, and edema. AJNR Am J Neuroradiol 17(6):1051–1055PubMed
19.
Ogura H, Takaoka M, Kishi M, et al (1998) Reversible MR findings of hemolytic uremic syndrome with mild encephalopathy. AJNR Am J Neuroradiol 19(6):1144–1145PubMed
Metadata
Title
Focal transient lesion in the splenium of the corpus callosum in three non-epileptic patients
Authors
Antônio José da Rocha
Fabiano Reis
Hugo Pereira Pinto Gama
Carlos Jorge da Silva
Flávio Túlio Braga
Antônio Carlos Martins Maia Júnior
Fernando Cendes
Publication date
01-10-2006
Publisher
Springer-Verlag
Published in
Neuroradiology / Issue 10/2006
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI
https://doi.org/10.1007/s00234-006-0116-x

Other articles of this Issue 10/2006

Neuroradiology 10/2006 Go to the issue

Diagnostic Neuroradiology

Meningiomas with conventional MRI findings resembling intraaxial tumors: can perfusion-weighted MRI be helpful in differentiation?

Diagnostic Neuroradiology

Analysis of the utility of diffusion-weighted MRI and apparent diffusion coefficient values in distinguishing central nervous system toxoplasmosis from lymphoma

Society News

European Society of Neuroradiology (ESNR)

Interventional Neuroradiology

Tentorial artery embolization in tentorial dural arteriovenous fistulas

Functional Neuroradiology

Comparison of cerebral blood volume and permeability in preoperative grading of intracranial glioma using CT perfusion imaging

Functional Neuroradiology

Functional MR study of a motor task and the Tower of London task at 1.0 T