Transient splenial lesion: Further experience with two cases

Abstract

Transient splenial lesions (TSL) of the corpus callosum are uncommon radiologic findings that are seen in a number of clinical conditions with varied etiologies. They were first described a decade earlier in patients with epilepsy and hence were thought to be seizure or seizure therapy related. Subsequently, more cases were described by different observers in diseases with different etiologies, and the list is still increasing. Awareness of these lesions is necessary as they are an uncommon finding and have to be differentiated from other infective/noninfective causes. MRI is the imaging modality of choice as these lesions are not seen on routine noncontrast CT scan. The authors here describe two cases which showed TSL, with complete/partial resolution on follow-up scans. The authors also present a review of the literature.

Keywords

MRI - splenium of corpus callosum - transient splenium lesion

• References

• 1 Chason DP, Fleckenstein JL, Ginsburg ML, Mendelsohn DB, Mathews D. Transient splenial edema in epilepsy: MR imaging evaluation. Presented at the annual meeting of the American Society of Neuroradiology, June 21-27, Seattle, WA, 1996.
• 2 Kim SS, Chang KH, Kim ST, Suh DC, Cheon JE, Jeong SW, et al. Focal lesion in the splenium of the corpus callosum in epileptic patients: antiepileptic drug toxicity ?. AJNR Am J Neuroradiol 1999;20:125-9.
• 3 Oztoprak I, Engin A, Gόmόs C, Egilmez H, Oztoprak B. Transient splenial lesions of the corpus callosum in different stages of evolution. Clin Radiol 2007;62:907-13.
• 4 Maeda M, Shiroyama T, Tsukahara H, Shimono T, Aoki S, Takeda K. Transient splenial lesion of the corpus callosum associated with antiepileptic drugs: evaluation by diffusion-weighted MR imaging. Eur Radiol 2003;13:1902-6.
• 5 Bulakbasi N, Kocaoglu M, Tayfun C, Ucoz T. Transient splenial lesion of the corpus callosum in clinically mild influenza-associated encephalitis/encephalopathy. AJNR Am J Neuroradiol 2006;27:1983-86.
• 6 Yaguchi M, Yaguchi H, Itoh T, Okamato K. Encephalopathy with isolated reversible splenial lesion of the corpus callosum. Intern Med 2005;44:1291-4.
• 7 Yeh IB, Tan LC, Sitoh YY. Reversible splenial lesion in clinically mild encephalitis. Singapore Med J 2005;46:726-30.
• 8 Ogura H, Takaoka M, Kishi M, Kimoto M, Shimazu T, Yoshioka T, et al. Reversible MR findings of haemolytic uremic syndrome with mild encephalopathy. AJNR Am J Neuroradiol 1998;19:1144-5.
• 9 Tada H, Takanashi J, Barkovich AJ, Oba H, Maeda M, Tsukahara H, et al. Clinically mild encephalitis/encephalopathywith reversible splenial lesion. Neurology 2004;63:1854-8.
• 10 Takanashi J, Barkovich AJ, Shiihara T, Tada H, Kawatani M, Tsukahara H, et al. Widening spectrum of a reversible splenial lesion with transiently reduced diffusion. AJNR Am J Neuroradiol 2006;27:836-8.
• 11 Cohen-Gadol AA, Britton JW, Jack CR Jr, Friedman JA, Marsh WR. Transient postictal magnetic resonance imaging abnormality of the corpus callosum in a patient with epilepsy. J Neurosurg 2002;97:714-7.
• 12 Gόven H, Delibaώ S, Comoπlu SS. Transient lesion in the splenium of the corpus callosum due to carbamazepine. Turk Neurosurg 2008;18:264-70.
• 13 Hegde A, Kei PL, Ahuja MS. The case of the vanishing splenial lesion. Br J Radiol 2009;82:262-3.
• 14 Roychowdhury S, Maldjian JA, Grossman RI. Multiple sclerosis: Comparison of trace apparent diffusion coefficients with MR enhancement pattern of lesions. Am J Neuroradiol 2000;21:869-74.