Callosal Disconnection Syndrome after Corpus Callosum Infarct: A Diffusion Tensor Tractography Study

Abstract

We report a patient who presented with callosal disconnection syndrome (CDS) and fiber disconnection on diffusion tensor tractography (DTT) after an infarct of the corpus callosum (CC). A 72-year-old woman presented with manifestations of CDS, including frontal alien hand syndrome (AHS), left agraphia, right hemiparesis, right somatosensory deficit, left neglect, and impaired visual recognition. DTT was performed for the evaluation of CC fibers, followed by comparison with DTT findings of normal subjects. DTT of the normal subject revealed bilateral extension of CC fibers to the frontal, parietal, and occipitotemporal cortices. By contrast, CC fibers of the patient revealed extensive disruption, with the exception of CC fibers passing through the anterior genu and the posterior splenium. The extensive disruption of CC fibers appears to explain the patient's various CDS symptoms. In brief, DTT could be useful for detection of CC lesions in patients with CDS.