J Clin Neurol.  2007 Mar;3(1):53-56. 10.3988/jcn.2007.3.1.53.

Mild Encephalopathy with Reversible Lesion in the Splenium of the Corpus Callosum and Bilateral Frontal White Matter

• Cho JS
• Ha SW
• Han YS
• Park SE
• Hong KM
• Han JH
• Cho EK
• Kim DE
• Kim JG

• KMID: 1700688
• DOI: http://doi.org/10.3988/jcn.2007.3.1.53

Abstract

A 59-year-old man visited an emergency room due to the sudden onset of severe dysarthria with a drowsy mental status. MRI demonstrated T2 prolongation and restricted diffusion involving the splenium of the corpus callosum and bilateral frontal white matter neurological signs and symptoms were mild, and the recovery was complete within a week. Follow-up MRI performed one month later revealed complete resolution of the lesions. The clinical and radiological courses were consistent with previously reported reversible isolated splenial lesions in mild encephalitis/encephalopathy except for the presence of frontal lesions. This case suggests that such reversible lesions can occur outside the splenium.

Keyword

Reversible Lesion; Splenium; Corpus Callosum; Encephalitis/Encephalopathy

MeSH Terms

Corpus Callosum*
Diffusion
Dysarthria
Emergency Service, Hospital
Follow-Up Studies
Humans
Magnetic Resonance Imaging
Middle Aged

Figure

• 

  Figure 1 On admission day, brain DWI (a) showed high-intensity signals in the splenium of the corpus callosum associated with symmetric bilateral frontal white-matter changes. (b) The same regions exhibited low ADC signals. (c) On the next day, brain T2-weighted MRI showed high-intensity signals in the same area. (d) Brain T1-weighted MRI demonstrated no high-intensity-signal changes. (e) Brain contrast-enhanced MRI showed no enhanced lesion.

• 

  Figure 2 One month later, follow-up brain diffusion- weighted (a), ADC (b), T2-weighted (c), and T1-weighted (d) MRI images showed no abnormal signal changes. (e) Brain contrast-enhanced MRI showed no enhanced lesion. The lesions in the SCC associated with symmetric bilateral frontal white-matter changes were completely resolved.

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