Cytotoxic Lesions of the Corpus Callosum Patterns and Etiologies: Insights from an Indian Cohort.

BACKGROUND AND

OBJECTIVES

The corpus callosum (CC) is the largest commissural pathway in the brain. The splenium of corpus callosum (SCC) represents the thickest and most posterior portion of the CC. Transient signal alterations in the SCC on magnetic resonance imaging (MRI) have been observed in various neurological and non-neurological conditions, termed cytotoxic lesions of the corpus callosum (CLOCCs). We aim to study the different MRI brain patterns in patients with CLOCCs and correlate probable etiologies with clinical and radiological presentations.

METHODS

During the study period of 8 years, 10,000 MRI brain scans were reviewed. A total of 127 (1.27%) patients had splenial involvement. Cases of splenial involvement due to stroke and tumors were excluded. Ultimately, 35 patients who had CLOCCs were enrolled in the study. After analyzing splenial lesions with respect to size, shape, involvement of the genu, and involvement of extracallosal sites, CLOCCs were further classified into dot sign, boomerang sign, double boomerang sign, and boomerang plus sign.

RESULTS

The dot sign was observed in 19 (54.28%), the boomerang sign in 3 (8.57%), the double boomerang sign in 3 (8.57%) patients, and the boomerang plus sign in 10 (28.57%) patients. The majority of the patients had seizures. The other probable etiologies included infections, hypernatremia, hypoglycemia, and headache.

CONCLUSIONS

CLOCCs is a clinicoradiological syndrome resulting from a wide variety of causes. MRI brain patterns can range from isolated involvement of the splenium to involvement of extracallosal sites, and these patterns may help identify the probable etiologies.