CYTOTOXIC LESIONS OF THE CORPUS CALLOSUM: MAGNETIC RESONANCE IMAGING FINDINGS AND ETIOLOGIC FACTORS

Abstract

Objective: Cytotoxic lesions of the corpus callosum (CLOCCs) are usually detected as a diffusion restriction in the splenium of the corpus callosum. They are rare secondary radiological findings associated with various clinical entities. The aim of this study is to evaluate the magnetic resonance imaging (MRI) findings and underlying clinical factors of cases with CLOCCs. Materials and Methods: The MRI images of 850 patients who were admitted to the emergency services between January 2017 and March 2021 with encephalopathy and epilepsy-like neurological complaints were scanned retrospectively. Twenty nine patients (20 men, 9 women) with CLOCCs were included in the study. Their radiological and clinical findings were evaluated. Results: The mean age was calculated as 26.4 years (5-72 years). The patients had neurological symptoms such as dysarthria, confusion, ataxia, syncope, epileptic seizure, and headache. Lesions were developed secondary to various infections in 20 (68.9%) patients. Diabetic decompensation was found in three patients and uremic decompensation in one patient. In the remaining patients, subarachnoid hemorrhage, asthma attack, trauma, high-dose lithium-levetiracetam intake and anti-epileptic drug withdrawal were responsible. Twenty patients had MRI control. In 16 (80%) patients, MRI findings returned to normal between 6 days and 8 months (median 30, Mean 53.8 days). One of the other 4 patients had partial regression, and 3 patients recovered with sequelae gliosis. Conclusion: CLOCCs are nonspecific MRI findings associated with a broad underlying clinical spectrum. They are usually reversible. Determination of the underlying clinical etiology, avoidance of an ischemic stroke and tumor-like misdiagnoses are important for appropriate patient management.