Saul R. Korey Department of Neurology, Montefiore Medical Center, Albert Einstein College of Medicine.
Stroke. 2020 Sep;51(9):e223-e226. doi: 10.1161/STROKEAHA.120.030434. Epub 2020 Jul 20.
Ischemic infarction of the corpus callosum is rare and infarction isolated to the corpus callosum alone rarer still, accounting for much <1% of ischemic stroke in most stroke registries. About half of callosal infarctions affect the splenium.
During a 2-week period, at the height of the coronavirus disease 2019 (COVID-19) pandemic in New York City, 4 patients at Montefiore Medical Center in the Bronx were found to have ischemic lesions of the splenium of the corpus callosum, 2 with infarction isolated to the corpus callosum.
All patients tested positive for COVID-19 and 3 had prolonged periods of intubation. All had cardiovascular risk factors. Clinically, all presented with encephalopathy and had evidence of coagulopathy and raised inflammatory markers.
Infarction of the splenium of the corpus callosum is exceedingly rare and a cluster of such cases suggests COVID-19 as an inciting agent, with the mechanisms to be elucidated.
胼胝体梗死很少见,单纯胼胝体梗死更罕见,在大多数卒中登记处中占缺血性卒中的比例<1%。约一半的胼胝体梗死影响胼胝体压部。
在 COVID-19 大流行期间的两周内,在纽约市布朗克斯区的蒙蒂菲奥里医疗中心发现了 4 例胼胝体压部的缺血性病变,其中 2 例为单纯胼胝体梗死。
所有患者的 COVID-19 检测均呈阳性,3 例患者长时间插管。所有患者均有心血管危险因素。临床上,所有患者均表现为脑病,并有凝血功能障碍和炎症标志物升高的证据。
胼胝体压部梗死极为罕见,此类病例聚集提示 COVID-19 可能是一个促发因素,其发病机制尚待阐明。