Clinical Analysis on Reversible Splenial Lesions of the Corpus Callosum_West China Medical Journal

Authors：

HU Xiaohui ¹ ,  YAO Changjiang ¹ , TANG Qianjun ² , LIU Zhishu ²

1. Department of Neurology, Jingzhou Center Hospital, Jingzhou, Hubei 434020, P. R. China; 2. Health Department of the Armed Police Contingents, Wuhan, Hubei 430070, P. R. China;

Corresponding author：

YAO Changjiang, Email: smilewheeler@163.com

Keywords：

胼胝体; 胼胝体压部; 细胞毒性水肿; 视幻觉; 定向功能障碍

DOI：

CNKI: 51-1356/R.20120214.1341.015

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目的　探讨可逆性胼胝体压部病变的临床特征和致病机制。方法　总结Pubmed和Springer数据库中2000年1月1日－2011年8月1日报道的年龄＞6岁的可逆性胼胝体压部病变患者的临床特征，分析该病可能的致病机制。结果　 14例患者中男7例，女7例；年龄（27.4 ± 15.6）岁，最小7岁，最大58岁；病因为发热、疫苗接种、感染、癫痫发作、接受抗癫痫药物或突然停用抗癫痫药治疗、接受四环素或氟尿嘧啶治疗、营养不良、慢性酒精消耗，临床症状出现率50%，为视幻觉、错觉、定向功能障碍、意识模糊、嗜睡、共济失调步态、急性尿潴留；可逆性胼胝体病变持续时间为（20.6 ± 14.5） d，最短2 d，最长50 d，影像学特征是T1加权成像低或等信号，T2加权成像、弥散加权成像高信号，表观弥散系数成像低信号，水抑制成像常无明显结构或信号异常发现，T1-钆对比剂增强成像无病灶强化。结论　可逆性胼胝体压部病变病因多样，临床表现复杂，致病机制可能主要为低钠血症、低血糖、精氨酸血管加压素功能紊乱、感染或药物毒性等导致胼胝体压部细胞毒性水肿。

Citation： HU Xiaohui,YAO Changjiang,TANG Qianjun,LIU Zhishu. Clinical Analysis on Reversible Splenial Lesions of the Corpus Callosum. West China Medical Journal, 2012, 27(2): 223-225. doi: CNKI: 51-1356/R.20120214.1341.015 Copy

1.	Kitami M, Kubo S, Nakamura S, et al. Acute urinary retention in a 23-year-old woman with mild encephalopathy with a reversible splenial lesion: a case report[J]. J Med Case Rep, 2011, 5: 159.
2.	Hara M, Mizuochi T, Kawano G, et al. A case of clinically mild encephalitis with a reversible splenial lesion (MERS) after mumps vaccination[J]. Brain Dev, 2011, 33(10): 842-844.
3.	Grühbaum B, Salzer H, Nasel C, et al. Reversible cytotoxic oedema in the splenium of the corpus callosum related to tetracycline therapy[J]. Pediatr Radiol, 2009, 40(10): 1693-1695.
4.	Arakawa C, Fujita Y, Imai Y, et al. Detection of group a rotavirus RNA and antigens in serum and cerebrospinal fluid from two children with clinically mild encephalopathy with a reversible splenial lesion[J]. Jpn J Infect Dis, 2011, 64(3): 204-207.
5.	Hong JM, Joo IS. A case of isolated and transient splenial lesion of the corpus callosum associated with disseminated Staphylococcus aureus infection[J]. J Neurol Sci, 2006, 250(1-2): 156-158.
6.	Tani M, Natori S, Noda K, et al. Isolated reversible splenial lesion in adult meningitis: a case report and review of the literature[J]. Intern Med, 2007, 46(18): 1593-1596.
7.	Öztoprak I, Engin A, Gümüs C, et al. Transient splenial lesions of the corpus callosum in different stages of evolution[J]. Clin Radiol, 2007, 62(9): 907-913.
8.	Takanashi JI, Barkovich AJ, Yamaguchi KI, et al. Influenza-associated encephalitis/encephalopathy with a reversible lesion in the splenium of the corpus callosum: a case report and literature review[J]. AJNR Am J Neuroradiol, 2004, 25(5): 798-802.
9.	Honda K, Nishimiya J, Sato H, et al. Transient splenial lesion of the corpus callosum after acute withdrawal of antiepileptic drug: a case report[J]. Magn Reson Med, 2006, 5(4): 211-215.
10.	Güven H, Deliba? S, Como?lu SS. Transient lesion in the splenium of the corpus callosum due to carbamazepine[J]. Turk Neurosurg, 2008, 18(3): 264-270.
11.	Maeda M, Tsukahara H, Terada H, et al. Reversible splenial lesion with restricted diffusion in a wide spectrum of diseases and conditions[J]. J Neuroradiol, 2006, 33(4): 229-236.
12.	Takashi K, Isoda H, Imai M, et al. Reversible focal splenial lesion of the corpus callosum on MR images in a patient with malnutrition[J]. Magn Reson Med, 2004, 3(4): 211-214.
13.	Masamitsu Y, Yaguchi H, Itoh T, et al. Encephalopathy with isolated reversible splenial lesion of the corpus callosum[J]. Intern Med, 2005, 44(12): 1291-1294.
14.	Matthew JT, Saadoun S, Bell BA, et al. Water movements in the brain: role of aquaporins[J]. Trends in Neurosci, 2007, 31(1): 37-43.
15.	Zenichiro K, Orii KE, Morimoto M, et al. A Transient lesion in the corpus callosum during rotavirus infection[J]. Pediatr Neurol, 2009, 41(6): 467-469.

1. Kitami M, Kubo S, Nakamura S, et al. Acute urinary retention in a 23-year-old woman with mild encephalopathy with a reversible splenial lesion: a case report[J]. J Med Case Rep, 2011, 5: 159.
2. Hara M, Mizuochi T, Kawano G, et al. A case of clinically mild encephalitis with a reversible splenial lesion (MERS) after mumps vaccination[J]. Brain Dev, 2011, 33(10): 842-844.
3. Grühbaum B, Salzer H, Nasel C, et al. Reversible cytotoxic oedema in the splenium of the corpus callosum related to tetracycline therapy[J]. Pediatr Radiol, 2009, 40(10): 1693-1695.
4. Arakawa C, Fujita Y, Imai Y, et al. Detection of group a rotavirus RNA and antigens in serum and cerebrospinal fluid from two children with clinically mild encephalopathy with a reversible splenial lesion[J]. Jpn J Infect Dis, 2011, 64(3): 204-207.
5. Hong JM, Joo IS. A case of isolated and transient splenial lesion of the corpus callosum associated with disseminated Staphylococcus aureus infection[J]. J Neurol Sci, 2006, 250(1-2): 156-158.
6. Tani M, Natori S, Noda K, et al. Isolated reversible splenial lesion in adult meningitis: a case report and review of the literature[J]. Intern Med, 2007, 46(18): 1593-1596.
7. Öztoprak I, Engin A, Gümüs C, et al. Transient splenial lesions of the corpus callosum in different stages of evolution[J]. Clin Radiol, 2007, 62(9): 907-913.
8. Takanashi JI, Barkovich AJ, Yamaguchi KI, et al. Influenza-associated encephalitis/encephalopathy with a reversible lesion in the splenium of the corpus callosum: a case report and literature review[J]. AJNR Am J Neuroradiol, 2004, 25(5): 798-802.
9. Honda K, Nishimiya J, Sato H, et al. Transient splenial lesion of the corpus callosum after acute withdrawal of antiepileptic drug: a case report[J]. Magn Reson Med, 2006, 5(4): 211-215.
10. Güven H, Deliba? S, Como?lu SS. Transient lesion in the splenium of the corpus callosum due to carbamazepine[J]. Turk Neurosurg, 2008, 18(3): 264-270.
11. Maeda M, Tsukahara H, Terada H, et al. Reversible splenial lesion with restricted diffusion in a wide spectrum of diseases and conditions[J]. J Neuroradiol, 2006, 33(4): 229-236.
12. Takashi K, Isoda H, Imai M, et al. Reversible focal splenial lesion of the corpus callosum on MR images in a patient with malnutrition[J]. Magn Reson Med, 2004, 3(4): 211-214.
13. Masamitsu Y, Yaguchi H, Itoh T, et al. Encephalopathy with isolated reversible splenial lesion of the corpus callosum[J]. Intern Med, 2005, 44(12): 1291-1294.
14. Matthew JT, Saadoun S, Bell BA, et al. Water movements in the brain: role of aquaporins[J]. Trends in Neurosci, 2007, 31(1): 37-43.
15. Zenichiro K, Orii KE, Morimoto M, et al. A Transient lesion in the corpus callosum during rotavirus infection[J]. Pediatr Neurol, 2009, 41(6): 467-469.

West China Medical Journal

Clinical Analysis on Reversible Splenial Lesions of the Corpus Callosum

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