Radiologic And Clinical Feature Of Corpus Callosal Infarction

Objective To study incidence, etiological factor,clinical manifestions and imaging features of corpus callosal infarction. Methods The clinical and imaging records of thirty-three inpatients with corpus callosal infarction diagnosed by MRI from 1609 patients in Anhui Provincial Hospital from April 2006 to April 2010 were analyzed retrospectively . Results①Our data shown that incidence of corpus callosum infarction was 2.05% and average age of onset was 62.5±8.93 years old. The major risk factors included hypertension, hyperlipoidemia and diabetes.②Hemiplegia was the most common clinical manifestation(93.9%),and the incidence in various parts of the corpus callosum infarction was very high. All of inpatients with merely corpus callosum infarction were paresis and leg weakness was usual. Furthermore, Upper and lower limbs were involved was not at the same degree. Cognitive decline (57.6%) was a major feature of corpus callosum infarction. Ataxia(45.5%), sensory disturbance(39.4%), language disorder(30.3%),affective disorder were followed. Apraxia, agraphia, alien hand syndrome were typical manifestations of corpus callosum infarction, While typical callosal disconnection syndrome was rarely seen (9.1%).③The positive rate of CT scan was lower, MRI had higher sensitivity and specificity for callosal infarction. 42 focus of infarction were found in 33 patients by MRI ,The main sites of infarction located mainly in the body and spleniumof corpus callosum(42.9%,35.7%), basal ganglia, centrum semiovale, brain stem,frontal lobe,parietal lobe, temporal lobe and occipital lobe were also involved.④Six Patients had isolated corpus callosal infarction, and 27 case also involved basal ganglia, centrum semiovale, brain stem and lobes of brain. and the incidence in basal ganglia (75.8%) was highest. 24 cases (72.7%) underwent Unilateral infarction and 9 case (27.3) underwent bilateral infarction, P<0.05;14 focus of infarction(33.3%) were found at left and 28 focus of infarction(66.7%) were found at right, P<0.05.⑤15 cases underwent Angiographies(MRA/CTA/DSA), The results were as follows: ACA atherosclerosis (6 stenoses and 3 occlusion) , Pericallosal artery atherosclerosis(3 stenoses and 2 occlusion) , MCA atherosclerosis (1 stenoses), PCA atherosclerosis (3 stenoses and 2 occlusion) , 2 case was normal.⑥The diagnosis of callosal infarction was not difficult according to the history and imaging examination, however, it needs to be differentiated with other diseases that likely involve corpus callostma, such as : Marchiafava-Bignami disease, multiple sclerosis, tumour.⑦After treatment, merely corpus callosal infarction was better prognosis relatively,limb motor function were improved in 22 patients, conscious disturbance aggravated in 5 patients, no improvement in 6 patient. Conclusion Incidence of corpus callosum infarction was lower and their clinical manifestations are complex and miscellaneous. Cognitive impairment and callosal disconnection syndrome should been tanken seriously. Cerebral MRI will be helpful to locate the site of corpus callosal infraction. Merely corpus callosal infarction was better prognosis relatively.