Corpus Callosal Injury in Head Trauma

Choe, Jong Won; Kim, Hun Joo; Jung, Hyun Ho; Han, Yong Pyo; Hu, Chul; Pyen, Jhin Soo; Whang, Kum

Abstract

OBJECTIVE
Corpus callosum is one of the common sites of brain lesion, whose involvement is an indicator of a more severe prognosis, produced by traumatic shearing stresses resulting in diffuse axonal injury. We analyzed the relationship between clinical parameters and outcome of traumatic brain injury with corpus callosal injury (CCI).
METHODS
From January, 1989 to June, 2006, 58 patients with contusion on corpus callosum, detected by computed tomography or magnetic resonance imaging, were selected among patients with head injury who were admitted to our hospital. Clinical records and radiological studies of all patients were reviewed and evaluated retrospectively.
RESULTS
CCI was most frequently observed in cases with impact to the frontal and parietal region. Fifty three patients (91.4%) had the lesion within the body and splenium of corpus callosum. The combined lesions with CCI were contusional hemorrhage (59.9%), subarachnoid hemorrhage (34.5%), skull fracture (31.0%), intraventricular hemorrhage (22.4%) in order. The good glasgow outcome score (GOS) group (good recovery & moderate disability) at discharge was revealed in 69.0% of total population. There was no definite statistical significance between GOS and impact site, combined lesions.
CONCLUSION
More than half of the patients with CCI have severe head injury, but this type of injury also occurs in nonfatal head injury. In our study, the 65% of patients with CCI showed a good outcome. The splenium was the frequent CCI site in patient with low initial glasgow coma scale (GCS). The poor outcome was associated with low initial GCS score, splenium lesion and brainstem lesion.