Brain & development · 2025
Etiology-specific diagnosis of cytotoxic lesions of the corpus callosum (CLOCC) in a single-center pediatric cohort: diagnostic challenges and outcome characteristics.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Ataş Yavuz, Eraslan Cenk, Ince Tuğce, Islamli Javid, Öcbe Pınar, Toprak Dilara Ece, Şen Gürsel, Ölçülü Cemile Büşra, Yilmaz Özlem, Acar Özlem, Ari Güliz Çırpanlı, Görgülü Gamze, Özkaya Pınar Yazıcı, Karapinar Bülent, Ekemen Coşkun, Bal Zümrüt Şahbudak, Şimşek Erdem, Kanmaz Seda, Yilmaz Sanem, Çalli Cem, Tekgül Hasan
Аннотация
OBJECTIVE: To evaluate the clinical and radiological characteristics of cytotoxic lesions of the corpus callosum (CLOCC) in a pediatric cohort.
METHODS: A pediatric CLOCC cohort consisting of 16 patients was derived from the radiology database of a single tertiary institution, Ege Children's Hospital. The CLOCC diagnosis was based on previously established magnetic resonance imaging (MRI) criteria by Starkey et al.: (i) a small, round lesion centered in the splenium; (ii) a lesion centered in the splenium extending laterally through adjacent callosal fibers; or (iii) a lesion located posteriorly in the splenium extending anteriorly. The MRI characteristics of the study cohort were re-evaluated with those of other neurologic disorder groups with corpus callosum involvement: vascular lesions (n = 200); demyelinating disorders (n = 114); autoimmune encephalitis (n = 23); traumatic brain injury (n = 151). Etiology-specific diagnostic approaches, therapeutic challenges, and clinical outcomes were also analyzed.
RESULTS: All patients displayed characteristic MRI features of CLOCC, including high signal on T2-weighted images, isointense-to-hypointense signal on T1-weighted images, and restricted diffusion on diffusion-weighted imaging (DWI), without contrast enhancement. The CLOCC lesions resolved within a median follow-up of 20 days (range: 5-150 days). The cohort was classified as infection-related CLOCC (62.5 %) and non-infectious CLOCC (37.5 %). The most frequent neurological symptoms at presentation were seizures (50 %) and altered consciousness (43.8 %). Immunotherapy was administered to 37.5 % of patients. None developed CLOCC-related neurological sequelae during the follow-up period.
CONCLUSION: Pediatric CLOCC is predominantly associated with symptoms related to underlying etiologic diseases, presenting diagnostic and therapeutic challenges in certain neurological conditions. The CLOCC lesions exhibit highly homogeneous MRI findings, though clinical outcomes and lesion resolution times vary depending on specific etiologies.
METHODS: A pediatric CLOCC cohort consisting of 16 patients was derived from the radiology database of a single tertiary institution, Ege Children's Hospital. The CLOCC diagnosis was based on previously established magnetic resonance imaging (MRI) criteria by Starkey et al.: (i) a small, round lesion centered in the splenium; (ii) a lesion centered in the splenium extending laterally through adjacent callosal fibers; or (iii) a lesion located posteriorly in the splenium extending anteriorly. The MRI characteristics of the study cohort were re-evaluated with those of other neurologic disorder groups with corpus callosum involvement: vascular lesions (n = 200); demyelinating disorders (n = 114); autoimmune encephalitis (n = 23); traumatic brain injury (n = 151). Etiology-specific diagnostic approaches, therapeutic challenges, and clinical outcomes were also analyzed.
RESULTS: All patients displayed characteristic MRI features of CLOCC, including high signal on T2-weighted images, isointense-to-hypointense signal on T1-weighted images, and restricted diffusion on diffusion-weighted imaging (DWI), without contrast enhancement. The CLOCC lesions resolved within a median follow-up of 20 days (range: 5-150 days). The cohort was classified as infection-related CLOCC (62.5 %) and non-infectious CLOCC (37.5 %). The most frequent neurological symptoms at presentation were seizures (50 %) and altered consciousness (43.8 %). Immunotherapy was administered to 37.5 % of patients. None developed CLOCC-related neurological sequelae during the follow-up period.
CONCLUSION: Pediatric CLOCC is predominantly associated with symptoms related to underlying etiologic diseases, presenting diagnostic and therapeutic challenges in certain neurological conditions. The CLOCC lesions exhibit highly homogeneous MRI findings, though clinical outcomes and lesion resolution times vary depending on specific etiologies.