Konomatsu Kazutoshi, Kakisaka Yosuke, Sato Shiho, Kubota Takafumi, Soga Temma, Ukishiro Kazushi, Jin Kazutaka, Mugikura Shunji, Aoki Masashi, Nakasato Nobukazu
Departments of Epileptology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
Departments of Neurology Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
Radiol Case Rep. 2024 Mar 5;19(5):2058-2061. doi: 10.1016/j.radcr.2024.02.058. eCollection 2024 May.
Lipoma of the corpus callosum, also known as pericallosal lipoma, is a rare congenital brain abnormality associated with corpus callosum dysgenesis or agenesis. Two morphological types are described: tubulonodular and curvilinear, with the latter being mostly asymptomatic. We present the case of a 30-year-old woman with epilepsy, whose magnetic resonance imaging revealed a "caterpillar sign" in the corpus callosum associated with a curvilinear pericallosal lipoma. The "caterpillar sign" in the corpus callosum showed low signal intensity on magnetization prepared rapid acquisition with gradient echo, high signal on fluid-attenuated inversion recovery, and low on susceptibility-weighted imaging, possibly indicating abnormal blood vessels penetrating from the ventricle to the posterior callosal vein. We need to be conscious of this unusual finding, particularly when considering surgical intervention in the corpus callosum in cases of pericallosal lipoma, to avoid vascular complications.
胼胝体脂肪瘤,也称为胼胝周脂肪瘤,是一种罕见的先天性脑异常,与胼胝体发育不全或发育缺失有关。胼胝体脂肪瘤有两种形态学类型:管状结节型和曲线型,后者大多无症状。我们报告一例30岁癫痫女性患者,其磁共振成像显示胼胝体出现“毛虫征”,伴有曲线型胼胝周脂肪瘤。胼胝体的“毛虫征”在磁化准备快速梯度回波序列上呈低信号强度,在液体衰减反转恢复序列上呈高信号,在磁敏感加权成像上呈低信号,这可能表明有异常血管从脑室穿入胼胝体后静脉。我们需要留意这一不寻常的发现,尤其是在考虑对胼胝周脂肪瘤患者的胼胝体进行手术干预时,以避免血管并发症。