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European Radiology
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Open Access 26-12-2023 | Magnetic Resonance Imaging | Review

Cytotoxic lesions of the corpus callosum: a systematic review

Authors: Selina Moors, Dominik Nakhostin, Dariya Ilchenko, Zsolt Kulcsar, Jay Starkey, Sebastian Winklhofer, Benjamin V. Ineichen

Published in: European Radiology | Issue 7/2024

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Abstract

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.
Appendix
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Literature
1.
Blaauw J, Meiners LC (2020) The splenium of the corpus callosum: embryology, anatomy, function and imaging with pathophysiological hypothesis. Neuroradiology 62:563–585CrossRefPubMedPubMedCentral
2.
Rolshoven J, Fellows K, Ania R, Tabaac BJ (2021) Vertigo and cytotoxic lesions of the corpus callosum: report with review of the literature. Case Rep Neurol Med 18:5573822
3.
Starkey J, Kobayashi N, Numaguchi Y, Moritani T (2017) Cytotoxic lesions of the corpus callosum that show restricted diffusion: mechanisms, causes, and manifestations. Radiographics 37:562–576CrossRefPubMed
4.
5.
Kontzialis M, Soares BP, Huisman T (2017) Lesions in the splenium of the corpus callosum on MRI in children: a review. J Neuroimaging 27:549–561CrossRefPubMed
6.
Moher D, Shamseer L, Clarke M et al (2015) Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev 4:1CrossRefPubMedPubMedCentral
7.
8.
Wells GA, Tugwell P, O’Connell D et al (2015) The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analyses
9.
Tsuji M, Chong PF, Yamashita F, Maeda K, Kira R (2019) Cytotoxic lesion of the corpus callosum exclusively at the genu in a case of callosal hypogenesis. J Neuroradiol 46:222–223CrossRefPubMed
10.
Galnares-Olalde J, Vázquez-Mézquita A, Gómez-Garza G et al (2019) Cytotoxic lesions of the corpus callosum caused by thermogenic dietary supplements. AJNR Am J Neuroradiol 40:1304–1308CrossRefPubMedPubMedCentral
11.
Ueda F, Yoshie Y, Aburano H, Hashimoto M, Matsui O, Gabata T (2014) Splenial and white matter lesions showing transiently-reduced diffusion in mild encephalopathy monitored with MR spectroscopy and imaging. Magn Reson Med Sci 13:271–275CrossRefPubMed
12.
Gellman SR, Ng Y-T (2018) Transient corpus callosal lesion presenting with alien hand syndrome. Pediatr Neurol 89:66–67CrossRefPubMed
13.
Cho J-S, Ha S-W, Han Y-S et al (2007) Mild encephalopathy with reversible lesion in the splenium of the corpus callosum and bilateral frontal white matter. J Clin Neurol 3:53–56CrossRefPubMedPubMedCentral
14.
Garcia-Monco JC, Cortina IE, Ferreira E et al (2011) Reversible splenial lesion syndrome (RESLES): what’s in a name? J Neuroimaging 21:e1-14CrossRefPubMed
15.
Moreau A, Ego A, Vandergheynst F et al (2021) Cytotoxic lesions of the corpus callosum (CLOCCs) associated with SARS-CoV-2 infection. J Neurol 268:1592–1594CrossRefPubMed
16.
Guo K, Lai X, Liu Y, Zhou D, Hong Z (2021) Anti-glial fibrillary acidic protein antibodies as a cause of reversible splenial lesion syndrome (RESLES): a case report. Neurol Sci 42:3903–3907CrossRefPubMedPubMedCentral
17.
Toi H, Yagi K, Matsubara S, Hara K, Uno M (2021) Clinical features of cytotoxic lesions of the corpus callosum associated with aneurysmal subarachnoid hemorrhage. AJNR Am J Neuroradiol 42:1046–1051CrossRefPubMedPubMedCentral
18.
Chen W-X, Liu H-S, Yang S-D et al (2016) Reversible splenial lesion syndrome in children: retrospective study and summary of case series. Brain Develop 38:915–927CrossRef
19.
Azuma J, Nabatame S, Katsura T et al (2016) Marked elevation of urinary β2-microglobulin in patients with reversible splenial lesions: a small case series. J Neurol Sci 368:109–112CrossRefPubMed
20.
Kallenberg K, Bailey DM, Christ S et al (2007) Magnetic resonance imaging evidence of cytotoxic cerebral edema in acute mountain sickness. J Cereb Blood Flow Metab 27:1064–1071CrossRefPubMed
21.
Takayama H, Kobayashi M, Sugishita M, Mihara B (2000) Diffusion-weighted imaging demonstrates transient cytotoxic edema involving the corpus callosum in a patient with diffuse brain injury. Clin Neurol Neurosurg 102:135–139CrossRefPubMed
22.
Prilipko O, Delavelle J, Lazeyras F, Seeck M (2005) Reversible cytotoxic edema in the splenium of the corpus callosum related to antiepileptic treatment: report of two cases and literature review. Epilepsia 46:1633–1636CrossRefPubMed
23.
24.
25.
Rasmussen C, Niculescu I, Patel S, Krishnan A (2020) COVID-19 and involvement of the corpus callosum: potential effect of the cytokine storm? AJNR Am J Neuroradiol 41:1625–1628PubMedPubMedCentral
26.
Moritani T, Smoker WR, Sato Y, Numaguchi Y, Westesson P-LA (2005) Diffusion-weighted imaging of acute excitotoxic brain injury. AJNR Am J Neuroradiol 26:216–228PubMedPubMedCentral
27.
Ma D, Matute C (1999) Expression of glutamate transporters in the adult bovine corpus callosum. Mol Brain Res 67:296–302CrossRef
28.
Henning A (2018) Proton and multinuclear magnetic resonance spectroscopy in the human brain at ultra-high field strength: a review. Neuroimage 168:181–198CrossRefPubMed
29.
Weiger M, Pruessmann KP (2019) Short-T(2) MRI: principles and recent advances. Prog Nucl Magn Reson Spectrosc 114–115:237–270CrossRefPubMed
30.
Weiger M, Froidevaux R, Baadsvik EL, Brunner DO, Rösler MB, Pruessmann KP (2020) Advances in MRI of the myelin bilayer. Neuroimage 217:116888CrossRefPubMed
31.
Baadsvik EL, Weiger M, Froidevaux R, Faigle W, Ineichen BV, Pruessmann KP (2022) Mapping the myelin bilayer with short‐T2 MRI: methods validation and reference data for healthy human brain. Magn Reson Med
32.
Hassan A, Josephs KA (2016) Alien hand syndrome. Curr Neurol Neurosci Rep 16:1–10CrossRef
33.
Kanda T, Ishii K, Kawaguchi H, Kitajima K, Takenaka D (2014) High signal intensity in the dentate nucleus and globus pallidus on unenhanced T1-weighted MR images: relationship with increasing cumulative dose of a gadolinium-based contrast material. Radiology 270:834–841CrossRefPubMed
34.
Garg N, Reddel SW, Miller DH et al (2015) The corpus callosum in the diagnosis of multiple sclerosis and other CNS demyelinating and inflammatory diseases. J Neurol Neurosurg Psychiatry 86:1374–1382PubMed
35.
Uchino A, Takase Y, Nomiyama K, Egashira R, Kudo S (2006) Acquired lesions of the corpus callosum: MR imaging. Eur Radiol 16:905–914CrossRefPubMed
36.
37.
Geibprasert S, Gallucci M, Krings T (2010) Alcohol-induced changes in the brain as assessed by MRI and CT. Eur Radiol 20:1492–1501CrossRefPubMed
38.
Lu P-l, Hodes JF, Zheng X, Hu X-y (2020) Reversible splenial lesion syndrome with some novel causes and clinical manifestations. Intern Med 59:2471–2480CrossRefPubMedPubMedCentral
39.
Tao J-j, Zhang W-j, Wang D et al (2015) Susceptibility weighted imaging in the evaluation of hemorrhagic diffuse axonal injury. Neural Regen Res 10:1879CrossRefPubMedPubMedCentral
40.
Grabner G, Kiesel B, Wöhrer A et al (2017) Local image variance of 7 Tesla SWI is a new technique for preoperative characterization of diffusely infiltrating gliomas: correlation with tumour grade and IDH1 mutational status. Eur Radiol 27:1556–1567CrossRefPubMed
Metadata
Title
Cytotoxic lesions of the corpus callosum: a systematic review
Authors
Selina Moors
Dominik Nakhostin
Dariya Ilchenko
Zsolt Kulcsar
Jay Starkey
Sebastian Winklhofer
Benjamin V. Ineichen
Publication date
26-12-2023
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 7/2024
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-023-10524-3

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