Kiliç Eda Coban, Aksoy Selma, Sahin Ahmet Riza, Uzun Nuray, Gökyigit Münevver
Bakirköy Mental Health Hospital, Neurology, Istanbul, Turkey.
Ideggyogy Sz. 2013 Jan 30;66(1-2):63-6.
Up to date the presentation of transient splenial lesions in corpus callosum were reported in diffusion weighted magnetic resonance imaging (MRI) only in epileptic patients and patients under antiepileptic therapy. A 41 year old male with no previous medical history was admitted to our clinic with symptoms of pneumonia. The neurological exam revealed stupor, but when awake his speech and orientation were normal. There were no meningeal irritation signs, cranial nerves, piramidal and cerebellar functions were normal. He had moderate respiratory distress and had bilateral rales in lower lobes while on auscultation. Laboratory tests revealed high liver function levels and high acute phase reactants. Arterial blood levels showed hypoxemia. A brain MRI showed a hypointensity in the splenium of corpus callosum on T1 weighted images. There was markedly increased signal in this region on diffusion weighted imaging and hypointense on ADC. The lesion was slightly hyperintense on T2 and FLAIR weighted images. A repeat brain MRI was done 30 days after the initial study and showed a complete resolution of the splenial lesion. Transient splenial lesions can be seen due to different mechanisms in different clinical settings. It should be noted that these lesions are mostly reversible. Unnecessary therapies and procedures should be avoided in these lesions.
迄今为止，仅在癫痫患者和接受抗癫痫治疗的患者中，在磁共振扩散加权成像（MRI）上报道过胼胝体一过性脾状病变的表现。一名41岁无既往病史的男性因肺炎症状入住我院。神经系统检查显示昏睡，但清醒时其言语和定向正常。无脑膜刺激征，颅神经、锥体束和小脑功能正常。听诊时他有中度呼吸窘迫，双下肺有啰音。实验室检查显示肝功能水平升高和急性期反应物升高。动脉血气显示低氧血症。脑部MRI在T1加权图像上显示胼胝体压部低信号。该区域在扩散加权成像上信号明显增加，在表观扩散系数（ADC）图上呈低信号。病变在T2加权和液体衰减反转恢复（FLAIR）加权图像上略呈高信号。在初次检查30天后进行了重复脑部MRI检查，显示胼胝体病变完全消退。在不同的临床情况下，由于不同的机制可出现一过性脾状病变。应注意这些病变大多是可逆的。对于这些病变应避免不必要的治疗和操作。
