Abstract
BackgroundReversible focal lesions in the splenium of the corpus callosum (SCC) or reversible splenial lesion syndrome are rare and little is known about their pathophysiology.Case summaryThe authors describe a case of a 65-year-old female who presented with fever, abnormal behaviour and mild hypernatremia. She was on neuropsychiatric treatment for bipolar disorder but denied any history of seizure. After an extensive workout to exclude infection, a clinical diagnosis of neuroleptic malignant syndrome (NMS) was made. Initial magnetic resonance imaging (MRI) of the brain showed a lesion in the SCC characterized by high-signal intensity on T2-weighted and FLAIR sequences with reduced signal intensity on T1-weighted sequence. Diffuse weighted imaging (DWI) showed restricted diffusion. There was no enhancement following Gadolinium administration. The follow-up MRI 8 weeks later showed complete resolution of the SCC lesion.ConclusionWhile the pathophysiology of reversible SCC lesions is still unclear, this case highlights the need to consider NMS in the differential diagnosis of reversible splenial lesion of the corpus callosum.
Highlights
Intensity modulated radiotherapy (IMRT) utilises small beamlets of ionising radiation to provide a highKhamfongkhruea et al Biomed Imaging Interv J 2012; 8(1):e5This page number is not for citation purposes use a respiratory gating system
The measurements by MapCheck show the gamma index of the planned absolute dose distribution in static and moving targets with gating, resulting in more than 96% passing for all dose rates
The absolute dose distribution measured by film for the static target was agreeable with the value of moving target with gating
Summary
Intensity modulated radiotherapy (IMRT) utilises small beamlets of ionising radiation to provide a highKhamfongkhruea et al Biomed Imaging Interv J 2012; 8(1):e5This page number is not for citation purposes use a respiratory gating system. Chen et al [5] studied the dosimetric effects caused by the respiratory motion during IMRT by using Kodak EDR2 films. They concluded that, without the gating system, the dose distribution of the stationary phantom was different from the moving one. Duan et al [7] studied the dosimetric effect of respiration-gated beam with IMRT delivery Their results suggested that low dose rate can reduce the effect of delay and catch-up cycle. Lin et al [2] determined the effect of radiation dose rate with moving target and the gated treatment using step-and-shoot IMRT delivery. The high dose rate gated stepand-shoot IMRT was dosimetrically accurate, shortened the delivery time, and was safe to use clinically
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