Infarction of the corpus callosum: a retrospective clinical investigation.

Shen Li,Xiao Zhang,Xiao-Mei Wu,Hua-Min Qin,Xin Sun,Yu-Meng Bai,Johannes Boltze,Jukka Jolkkonen,Su-Ping Wang,Jeroen Hendrikse

doi:10.1371/journal.pone.0120409

Abstract

ObjectivesThe aim of this study was to investigate patients with ischemic infarctions in the territory of the corpus callosum to advance our understanding of this rare stroke subtype by providing comprehensive descriptive and epidemiological data.MethodsFrom January 1, 2010 to June 30, 2014, all cases of acute ischemic stroke diagnosed by clinical manifestation and diffusion weighted imaging in Dalian Municipal Central Hospital were investigated. The patients presenting with corpus callosum infarctions were selected and further allocated into genu and/or body and splenium infarction groups. Proportion, lesion patterns, clinical features, risk factors and etiology of corpus callosum infarction were analyzed.ResultsOut of 1,629 cases, 59 patients (3.6%) with corpus callosum infarctions were identified by diffusion weighted imaging, including 7 patients who had ischemic lesions restricted to the corpus callosum territory. Thirty six patients had lesions in the splenium (61.0%). Corpus callosum infarction patients suffered from a broad spectrum of symptoms including weakness and/or numbness of the limbs, clumsy speech, and vertigo, which could not be explained by lesions in corpus callosum. A classical callosal disconnection syndrome was found in 2 out of all patients with corpus callosum infarctions. Statistical differences in the risk factor and infarct pattern between the genu and/or body group and splenium group were revealed.ConclusionCorpus callosum infarction and the callosal disconnection syndrome were generally rare. The most susceptible location of ischemic corpus callosum lesion was the splenium. Splenium infarctions were often associated with bilateral cerebral hemisphere involvement (46.2%). The genu and/or body infarctions were associated with atherosclerosis. The most common cause of corpus callosum infarction probably was embolism.

Highlights

The corpus callosum (CC) is the largest white matter tract in the human brain, interconnecting homologous association areas of both hemispheres with approximately 180 million callosal fibers passing through it [1]
Out of 1,629 cases, 59 patients (3.6%) with corpus callosum infarctions were identified by diffusion weighted imaging, including 7 patients who had ischemic lesions restricted to the corpus callosum territory
Corpus callosum infarction patients suffered from a broad spectrum of symptoms including weakness and/or numbness of the limbs, clumsy speech, and vertigo, which could not be explained by lesions in corpus callosum

Summary

Introduction

The corpus callosum (CC) is the largest white matter tract in the human brain, interconnecting homologous association areas of both hemispheres with approximately 180 million callosal fibers passing through it [1]. The rostrum and genu are supplied by the subcallosal and the medial callosal artery, respectively. Both vessels are derived from the anterior communicating artery. The pericallosal artery, a continuation of the anterior cerebral artery (ACA), gives rise to four branches providing the majority of blood supply to the CC body. The posterior pericallosal artery, a branch of the posterior cerebral artery (PCA), is a short penetrating arteriole providing blood supply to the splenium. There are anastomoses between the callosal branches of ACA and PCA near the splenium tip. Isolated CC-supplying ACA branches or PCA occlusion does not necessarily result in an interruption of blood supply and subsequent infarction [3]. The CC infarction syndrome is relatively rare with only a few, mainly small-scale systematic clinical investigations being reported

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