Splenium of Corpus Callosum

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Case Report Mycobacterium tuberculosis infection with clinically mild encephalitis/encephalopathy accompanied by reversible splenium lesion of the corpus callosum: a case report and analysis

Case Report Mycobacterium tuberculosis infection with clinically mild encephalitis/encephalopathy accompanied by reversible splenium lesion of the corpus callosum: a case report and analysis

The results of MRI lesions of the brain are shown in Figure 1. It was found that the lesions of the brain involved the splenium of corpus callosum and white matter of bilateral radial area (Figure 1), and visible slug high density in the left upper lobe backend and surrounding patchy high-density shadow appeared 3 days after pathogenesis (Figure 2A-C). The slug high density became smaller and the surrounding patchy high-density shadow became larger when reviewed after 3 months (Figure 2D-F). The MRI lesions of the brain involved only the corpus callosum 25 days after diagnosis, and
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Impaired visual short term memory capacity is distinctively associated with structural connectivity of the posterior thalamic radiation and the splenium of the corpus callosum in preterm born adults

Impaired visual short term memory capacity is distinctively associated with structural connectivity of the posterior thalamic radiation and the splenium of the corpus callosum in preterm born adults

A whole-report paradigm of briefly presented letter arrays based on the computationally formalized Theory of Visual Attention (TVA) was used to quantify parameter vSTM capacity in 26 preterm- and 21 full-term-born adults. Fractional anisotropy (FA) of posterior thalamic radiations and the splenium of the corpus callosum obtained by diffusion tensor imaging were analyzed by tract-based spatial statistics and used as proxies for cortico-thalamic and cortico-cortical structural connectivity.

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Focal Lesion in the Splenium of the Corpus Callosum in Epileptic Patients: Antiepileptic Drug Toxicity?

Focal Lesion in the Splenium of the Corpus Callosum in Epileptic Patients: Antiepileptic Drug Toxicity?

phies (especially adrenoleukodystrophy), AIDS de- mentia complex, and Marchiafava-Bignami dis- ease, may involve the corpus callosum (2–5). The MR imaging findings of these entities have been well described and appear to be different from those found in the epileptic patients in our study. In patients with early cognitive impairment due to HIV infection, abnormalities in the region of the splenium of the corpus callosum and in the crura of the fornix may be seen on MR images (3). Mar- chiafava-Bignami disease may cause lesions in the splenium of the corpus callosum, which are re- versed when these patients receive vitamin B sup- plement (5). In our patients, these were excluded by both the clinical setting and the MR imaging findings.
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Impaired visual short term memory capacity is distinctively associated with structural connectivity of the posterior thalamic radiation and the splenium of the corpus callosum in preterm born adults

Impaired visual short term memory capacity is distinctively associated with structural connectivity of the posterior thalamic radiation and the splenium of the corpus callosum in preterm born adults

Menegaux, Aurore, Meng, Chun, Neitzel, Julia, Bäuml, Josef G., Müller, Hermann J., Bartmann, Peter, Wolke, Dieter, Wohlschläger, Afra M., Finke, Kathrin and Sorg, Christian. (2017) Impaired visual short-term memory capacity is distinctively associated with structural connectivity of the posterior thalamic radiation and the splenium of the corpus callosum in preterm-born adults. NeuroImage, 150 . pp. 68-76.

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Abscess in the Splenium of the Corpus Callosum Treated with Direct Drainage via an Occipital Interhemispheric Approach

Abscess in the Splenium of the Corpus Callosum Treated with Direct Drainage via an Occipital Interhemispheric Approach

Lesions in the corpus callosum typically represent malignant tumors such as glioblastoma or lymphoma, because of its compact structure comprising tightly packed white-matter tracts. Brain abscess is rarely seen in the corpus callosum. To the best of our knowledge, solitary bacterial ab- scess confined to the splenium of the corpus callosum has not been reported previously. We re- port the case of a 72-year-old woman with rapidly progressing disturbance of consciousness fol- lowing 1 week of antibiotic treatment for bacterial meningitis. Magnetic resonance imaging dem- onstrated a ring-enhancing round mass located in the splenium of the corpus callosum on gadoli- nium-enhanced T1-weighted imaging, also showing a bright signal on diffusion-weighted imaging. The patient underwent occipital craniotomy and direct drainage of the lesion in the splenium through the interhemispheric fissure and achieved complete recovery. Brain abscess should be considered among the differential diagnoses for lesions in the splenium of the corpus callosum. An occipital interhemispheric approach to the splenium might be an important option in cases of brain abscess.
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A reversible lesion of the corpus callosum splenium with adult influenza associated encephalitis/encephalopathy: a case report

A reversible lesion of the corpus callosum splenium with adult influenza associated encephalitis/encephalopathy: a case report

Case presentation: A previously healthy 35-year-old man presented with acute progressive tetraplegia, transcortical motor aphasia and a mild decrease in his consciousness during his recovery after receiving oseltamivir phosphate treatment, and influenza type A antiviral medication. The initial magnetic resonance imaging study at day 1 showed symmetrical diffuse lesions in the white matter and a lesion on the central portion of the corpus callosum splenium. These findings had resolved on follow-up studies at day 8 and day 146. His neurological deficits mostly recovered within 12 hours following methylprednisolone pulse therapy. The levels of interleukin-6 and interleukin-10 in his blood and cerebrospinal fluid were initially elevated, but rapidly decreased to normal levels by day 8.
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Influenza Associated Encephalitis/Encephalopathy with a Reversible Lesion in the Splenium of the Corpus Callosum: A Case Report and Literature Review

Influenza Associated Encephalitis/Encephalopathy with a Reversible Lesion in the Splenium of the Corpus Callosum: A Case Report and Literature Review

glucose (61 mg/dL). Electroencephalography showed normal basic activity with no paroxysmal discharge. Rapid antigen- detection assay and PCR from a nasopharyngeal swab revealed influenza B, allowing a diagnosis of IAEE, and therapy of oseltamivir phosphate was begun. The influenza genome was not detected by PCR in his CSF sample. His clinical condition improved rapidly, with complete recovery on the following day (day 5). MR imaging on day 5 revealed a lesion in the central splenium of the corpus callosum and symmetric lesions in the centrum semiovale, medial to the central sulci, with slight hyperintensity compared with surrounding white matter on fluid-attenuated inversion recovery images (Fig 2A) and isoin- tensity on spin-echo T1-weighted images without contrast en- hancement. DWI (Fig 2B and C) showed markedly high signal intensity, and the ADC maps (Fig 2D and E) demonstrated decreased ADC values of the lesions (ADC of the central splenium ⫽ 0.325 ⫻ 10 ⫺3 mm 2 /s). Follow-up study on day 10
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Focal Lesion in the Splenium of the Corpus Callosum on FLAIR MR Images: A Common Finding with Aging and after Brain Radiation Therapy

Focal Lesion in the Splenium of the Corpus Callosum on FLAIR MR Images: A Common Finding with Aging and after Brain Radiation Therapy

similar distribution to that of deep white matter dis- ease seen in older patients and those with atheroscle- rotic risk factors (2). In the diffuse form, the abnor- malities are often symmetric when whole-brain radiation therapy has been given and range from small foci of abnormal signal intensity at the angle of the lateral ventricles to confluent signal intensity ab- normality involving most of the cerebral white matter. Focal lesions following radiation therapy, though un- common, were initially described nearly 71 years ago (23). These rare lesions usually manifest as a necrotic mass lesion with an unpredictable but often poor clinical outcome (24). Pathologic studies have dem- onstrated that focal and diffuse radiation changes in the brain have a similar microscopic appearance, ranging from mild characteristic vascular changes to coagulative necrosis (21). MR imaging is exquisitely sensitive for detecting the subtle T2 prolongation associated with the vasogenic edema from damage to the capillary endothelium and axonal demyelination commonly seen in radiation-induced white matter dis- ease. After MR imaging evaluation of 18 patients who had received fractionated brain radiation therapy an average of 7.2 months before imaging, we determined that a focal lesion in the corpus callosum is commonly apparent on FLAIR images (16 of 18 patients). This signal intensity abnormality ranged from a small lin- ear band along the undersurface of the splenium, to confluent involvement of the splenium. Furthermore, this lesion may be seen in the absence of the diffuse deep white matter signal intensity abnormality com- monly seen following radiation therapy. Of the 10 patients with pre- and posttherapy images available, eight of 10 patients displayed normal signal intensity before radiation therapy and focal increased abnor- mal signal intensity in the splenium following therapy. These findings suggest that the splenium may be par- ticularly sensitive to radiation therapy. It is of consid- erable interest to the authors that one of the patients in group 1 with a lesion in the splenium had prior stereotactic radiation therapy for an acoustic tumor that did not include the splenium and two others had only upper chest radiation therapy. Although the le- sions we report typically involved the splenium in all cases, it is not at all clear that the pathogenesis in the aging population and that in the radiation cases are the same. In fact, the findings at autopsy suggest that these may represent different lesions.
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Diffusion Weighted MR Imaging Findings of Acute Necrotizing Encephalopathy

Diffusion Weighted MR Imaging Findings of Acute Necrotizing Encephalopathy

edema. On diffusion-weighted images, the central core of the pontine tegmenta, the cerebellar deep white matter, the upper part of vermis, both edges of the splenium of corpus callosum, and the deep cerebral white matter demonstrated low ADC values, consistent with acute cerebral infarction. The periph- eral portions of these lesions registered high ADC values char- acteristic of vasogenic edema. On the basis of the MR findings, clinical presentation, and laboratory data, the diagnosis of acute necrotizing encephalopathy secondary to an influenza A viral agent was established. The patient’s condition was critical for 3 weeks, after which time she began to improve slowly. MR images of the patient’s brain obtained on the 25th day of her hospitalization revealed dramatic changes (Fig 3A–C). Al- though her condition improved somewhat, the patient never attained her premorbid level of consciousness or neurologic function. She was comatose for 20 days and exhibited no re- sponse to verbal commands or painful stimuli. On her 30th day of hospitalization, the patient’s consciousness improved mini- mally. She is currently living with a severe neurologic disability as a result of her illness.
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Clinical and Neuroradiological Spectrum of Metronidazole Induced Encephalopathy: Our Experience and the Review of Literature

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The most remarkable feature of this disease is complete or near- complete resolution of the original lesions on follow-up MRIs [28]. Some researchers have postulated that initial lower values of ADC may predict poor outcome [45]. However, sometimes lesions persist despite an initial normal ADC value and hence it cannot be concluded with certainty that reversibility of the lesions depends on ADC values at presentation [43]. Researchers have noted that reduction of peaks of lactate after a follow-up time of 3 weeks can be used to differentiate it from a pure mitochondrial pathology [45]. It has also been hypothesized that there could be an anatomical basis of preference with respect to non resolution of lesions. Some areas like inferior olivary nuclei or splenium of corpus callosum have been reported earlier as sites of non resolution [28,29]. However, the persistence of inferior olivary hypertrophy as reported, may have resulted due to the interruption of the circuit of the Guillain- Mollaret triangle and not necessarily induced by metronidazole therapy [29]. So, it can be concluded from these findings that radiological non-resolution may be observed in cases where there is initial diffusion restriction with low ADC values and in lesions of corpus callosum specifically. Our experience regarding resolution has been mixed i.e. out of 3 patients who had lesions of corpus callosum, {2 in the splenium (one in isolation and other in conjugation with other areas) and one in the body and genu}, 2 resolved completely and in one case where there were lesions of genu and body, there was only partial resolution. ADC values were available only for 2 cases and were high in both of them including the case where genu and body was involved with partial improvement after drug withdrawal and also in the case where splenium was involved in isolation.
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Encephalitis with reversible splenial and deep cerebral white matter lesions associated with Epstein–Barr virus infection in adults

Encephalitis with reversible splenial and deep cerebral white matter lesions associated with Epstein–Barr virus infection in adults

Notes: at 7 days after admission, cranial Mri showed abnormal signal intensity in the bilateral thalamus, para-lateral ventricle white matter, and splenium of corpus callosum; iso-signal intensity on T1-weighted images; mild hypersignal intensity on T2-weighted images; significant contrast enhancement of the cerebral pia mater and tentorium of right cerebellum; hypersignal intensity in bilateral periventricular white matter and splenium of corpus callosum on DWi and FLair images. On day 30, cranial Mri showed that lesions in the splenium of corpus callosum almost disappeared. abnormal signal intensity in bilateral periventricle white matter reduced. Contrast enhancement of the cerebral pia mater significantly decreased. The enhancement of the tentorium of right cerebellum mildly decreased.
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Adrenoleukodystrophy: a scoring method for brain MR observations

Adrenoleukodystrophy: a scoring method for brain MR observations

Posterior white matter pattern 44 patients, 80% Parietooccipital white matter Splenium of corpus callosum Frequent visual and auditory pathway Occasional corticospinal tract Anterior whi[r]

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Reversible splenial lesion syndrome associated with encephalitis/encephalopathy presenting with great clinical heterogeneity

Reversible splenial lesion syndrome associated with encephalitis/encephalopathy presenting with great clinical heterogeneity

We performed a retrospective observational study in an academic hospital. Patients with isolated lesion in the splenium of corpus callosum visited in the first affili- ated hospital of Nanchang University between January 2012 and July 2015 were screened for the study. We identified all patients by searching our MRI report sys- tem using keyword “restricted diffusion and isolated SCC lesion”. Exclusion criteria include epilepsy-related RESLES, RESLES with additional lesions in white mat- ter, and cases without follow-up MRI. We reviewed and analyzed MRI scans and clinical charts of these pa- tients, including information about symptoms, treatments, prognosis, electroencephalogram (EEG), and results of cerebrospinal fluid (CSF) analysis. The clinical data and radiological examinations were independently evalu- ated by at least two neurologists firstly. A reversible isolated SCC lesion is defined as a lesion involving the central portion of SCC without any other lesions on the first MRI, which disappears on the follow-up scan- ning. According to the literatures and clinician consen- sus, the diagnosis of encephalitis had been defined as acute onset of brain dysfunction such as acute fever, headache, seizures, delirious behavior, and disorders of
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PubMedCentral-PMC5320449.pdf

PubMedCentral-PMC5320449.pdf

Emerging neuroimaging research suggests that antisocial personality disorder (ASPD) may be linked to abnormal brain anatomy, but little is known about possible impairments of white matter microstructure in ASPD, as well as their relationship with impulsivity or risky behaviors. In this study, we systematically investigated white matter abnormalities of ASPD using diffusion tensor imaging (DTI) measures: fractional anisotropy (FA), axial diffusivity (AD), and radial diffusivity (RD). Then, we further investigated their correlations with the scores of impulsivity or risky behaviors. ASPD patients showed decreased FA in multiple major white matter fiber bundles, which connect the fronto-parietal control network and the fronto-temporal network. We also found AD/RD deficits in some additional white matter tracts that were not detected by FA. More interestingly, several regions were found correlated with impulsivity or risky behaviors in AD and RD values, although not in FA values, including the splenium of corpus callosum, left posterior corona radiate/posterior thalamic radiate, right superior longitudinal fasciculus, and left inferior longitudinal fasciculus. These regions can be the potential biomarkers, which would be of great interest in further understanding the pathomechanism of ASPD.
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Sonographic characteristics of the cavum velum interpositum

Sonographic characteristics of the cavum velum interpositum

The cavum velum interpositum (CVI) represents a potential space above the tela choroidea of the third ventricle and below the columns of the fornices (Fig 1A) (1, 2). The anatomic location of the CVI is in close approximation to the crus of the fornices and the splenium of the corpus callosum in the pineal region (Fig 1B and C). Recently, we encountered cystlike structures in the pineal region on routine cranial sonograms, mainly in preterm infants. Be- cause the pineal gland is normally surrounded by the echogenic nondistended quadrigeminal cistern, a sonolucent structure seen in this region may raise concerns about the presence of an arachnoid cyst or pineal gland cyst, the latter of which is relatively uncommon in children, occurring in only 0.6% of routine MR studies relative to 2.6% in the adult population (3). To obviate a potential dilemma of diagnosing a true cystic lesion on an otherwise routine cranial sonogram, it is important to determine whether a cystlike structure within the area of the
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Altered White-Matter Microstructure in Conduct Disorder Is Specifically Associated with Elevated Callous-Unemotional Traits

Altered White-Matter Microstructure in Conduct Disorder Is Specifically Associated with Elevated Callous-Unemotional Traits

Abstract Adolescents with conduct disorder (CD) and elevated callous-unemotional (CU) traits have been reported to present with a more severe and persistent pattern of antisocial behaviour than those with low levels of CU traits. However, relatively few studies have investigated whether there are differences in brain structure between these subgroups.We acquired diffusion tensor imaging data and used tract-based spatial statistics (TBSS) to compare adolescents with CD and high levels of CU traits (CD/ CU+; n = 18, CD and low levels of CU traits (CD/CU-; n = 17) and healthy controls (HC; n = 32) on measures of fractional anisotropy (FA), axial (AD), radial (RD) and mean (MD) diffusivity. Compared to CD/CU- adolescents, those with CD/CU+ presented increased FA and reduced RD and MD (lower diffusivity) in several tracts including: body and splenium of the corpus callosum, right inferior longitudinal fasciculus, ILF; right inferior fronto-occipital fasciculus, IFOF; left superior longitudinal fasciculus, SLF; left cerebral peduncle, bilateral internal capsule, left superior and posterior corona radiata, bilateral thalamic radiation and left external capsule. In addition, relative to CD/CU- individuals, adolescents with CD/CU+ showed lower diffusivity (indexed by reduced RD and MD) in left uncinate fasciculus and bilateral fornix. Finally, relative to healthy controls, CD/CU+ individuals showed lower diffusivity (reduced RD) in the genu and body of the corpus callosum and left anterior corona radiata. These results suggest that CD/CU+ individuals present with white-matter microstructural abnormalities compared to both CD/CU- individuals and age-matched healthy controls. This finding is consistent with emerging evidence suggesting that CD/ CU+ represents a distinct subtype of CD, and illustrates the importance of accounting for heterogeneity within CD populations.
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Diffusion Tensor Imaging and Fiber Tractography in Children with Craniosynostosis Syndromes

Diffusion Tensor Imaging and Fiber Tractography in Children with Craniosynostosis Syndromes

age did not have a statistically significant effect on DTI parameters and was therefore excluded from our model. In total, we tested 4 diffusion properties (FA, MD, AD, and RD) and 11 WM struc- tures (corpus callosum [genu, corpus, splenium, and total], bilateral cingulate gyrus, fornix, bilateral corticospinal tracts, medial cerebellar peduncle, and mean WM), resulting in 44 comparisons between patients with craniosynostosis syn- dromes and controls. A Bonferroni correction was performed, and a P value ⬍ .001 (P value ⫽ .05/44) was considered statis- tically significant. The intra- and interobserver reliability was tested by average-measures 2-way mixed intraclass correlation coefficients.
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MR Quantitation of Volume and Diffusion Changes in the Developing Brain

MR Quantitation of Volume and Diffusion Changes in the Developing Brain

RESULTS: Water diffusion of the whole brain, caudate, thalamus, genu and splenium of the corpus callosum, and PVWM decreased during maturation, with the most significant change within the first 2 years. Robust negative correlations were found between age and the measured average diffusion constant (D av ) values in each of the measured locations (P < .005). Volumes

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Axonal chronic injury in treatment-naïve HIV+ adults with asymptomatic neurocognitive impairment and its relationship with clinical variables and cognitive status

Axonal chronic injury in treatment-naïve HIV+ adults with asymptomatic neurocognitive impairment and its relationship with clinical variables and cognitive status

of RD values can be seen in a few WM tracts (genu of corpus callosum and superior corona radiate), which in- dicates myelin damage. A possible reason is that HIV- infected patients in the previous study were classified into ADC stage 0 according to the MSK classification. While MSK is a decent scale to globally express the state of cognitive functioning, it is not very sensitive to changes in less affected patients. The Frascati scale used in the current study may be more sensitive to identify and classify individuals with subclinical impairment. More detailed neuropsychological assessment for earlier HIV-infected patients is the novel element of the current study relative to the previous study. Corrêa et al. found that HIV patients with planning deficits had significantly decreased FA, increased MD and RD values, predomin- antly in frontal lobes, genu and splenium of the corpus callosum, and much less widespread abnormalities were seen in the AD values compared with normal controls. HIV+ patients with planning deficits also had signifi- cantly decreased FA values and increased MD and RD values in some white matter regions compared to those without planning deficits [40]. No significant abnormal- ities AD values were seen between the two groups. These results indicated that RD abnormal values pre- dominated in the areas of decreased FA compared to AD values, suggesting that demyelination could play a role in the physiopathology of HIV-related WM injury, which is not completely consistent with our results. The possible reason for the difference between the two re- sults was that participants in the previous article all re- ceived ART, and with longer known infection. Antiretroviral drugs may be injurious to brain cell ele- ments. The influence of treatment on brain structure and function are less clear [41]. HIV+ patients on low CNS penetration ART had a significantly greater fMRI response amplitude compared to the HIV+ patients on high CNS penetration ART or normal controls [42]. To the best of our knowledge, no studies have detected the effects of ART regimen CNS penetration effectiveness on WM microstructure. Effects of treatment should be explored in future studies.
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PubMedCentral-PMC4840090.pdf

PubMedCentral-PMC4840090.pdf

The human brain undergoes dramatic change during the first years of life, yet few studies have examined longitudinal trajectories of brain development in young infants, and fewer yet have explored the association between longitudinal brain development and language ability. In the current study we provide evidence that the trajectory of 6 to 24 month white matter fiber tract development is related to language production at 24 months in typically developing infants. The strongest brain-behavior association was found in the splenium of the corpus callosum, a fiber tract that courses through the posterior hub of the default mode network and supports orienting to salient stimuli. Visual orienting has been shown to facilitate language acquisition through label mapping and consequently the splenium may support emerging language production through its role in visual orienting. Infants with superior language at 24 months displayed the greatest change over time in fractional anisotropy (FA) development from 6 to 24 months of age. Similar results were reported for radial diffusivity (RD), suggesting that differences in axon packing density and myelination may be driving the FA results, an interpretation consistent with previous work by Elison and colleagues and Wolff and colleagues (Elison, Paterson, et al., 2013; Wolff et al., 2015). Results did not support an association between early language production and classic perisylvian fiber tracts including the arcuate fasciculus, uncinate fasciculus, and inferior longitudinal fasciculus. This bolsters the position that the classic model of language-related neural circuitry cannot be downwardly extended to infants (Poeppel & Hickok, 2004). We also observed some evidence for structure-function specificity in that development of the splenium was not significantly associated with motor development, suggesting that this structure may facilitate the acquisition of spoken language but not all aspects of development. The findings presented here also bring attention to two matters often
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