Al-Edrus Sa, Norzaini R, Chua R, Puvanarajah Sd, Shuguna M, Muda S
Biomed Imaging Interv J. 2009 Oct;5(4):e24. doi: 10.2349/biij.5.4.e24. Epub 2009 Oct 1.
Reversible focal lesions in the splenium of the corpus callosum (SCC) or reversible splenial lesion syndrome are rare and little is known about their pathophysiology.
The 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.
While 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.
胼胝体压部可逆性局灶性病变或可逆性胼胝体压部病变综合征较为罕见，其病理生理学鲜为人知。
作者描述了一例65岁女性患者，表现为发热、行为异常和轻度高钠血症。她正在接受双相情感障碍的神经精神治疗，但否认有任何癫痫病史。在进行了广泛检查以排除感染后，临床诊断为抗精神病药恶性综合征（NMS）。最初的脑部磁共振成像（MRI）显示胼胝体压部有一个病变，在T2加权和液体衰减反转恢复（FLAIR）序列上表现为高信号强度，在T1加权序列上信号强度降低。弥散加权成像（DWI）显示弥散受限。给予钆剂后无强化。8周后的随访MRI显示胼胝体压部病变完全消退。
虽然可逆性胼胝体压部病变的病理生理学仍不清楚，但该病例强调在胼胝体可逆性病变的鉴别诊断中需要考虑NMS。
