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AJNR - American Journal of Neuroradiology

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Corpus Callosum Infarcts with Atypical Clinical and Radiologic Presentations

David L. Kasow^a,b, Sylvie Destian^a, Carl Braun^a, John C. Quintas^a, Nolan J. Kagetsu^a and Carl E. Johnson^a

^a From the Departments of Radiology (D.L.K., S.D., N.J.K., C.E.J.) and Neurology (C.B.), St. Luke's-Roosevelt Hospital Center, New York, NY, and the Department of Radiology (J.C.Q.), New York University Medical Center, New York, NY.
^b Address reprint requests to David L. Kasow, M.D., 150 East 85th Street, Apt. 8 H, New York, NY 10028.

View larger version (79K): [in a new window]   FIG 1. Case 1. Axial postcontrast CT image (A) and coronal postcontrast T1-weighted image (B) (480/20/1 [TR/TE/excitations]) show a non-enhancing lesion within both sides of the genu (curved arrow) of the corpus callosum with mass effect on the frontal horns. Axial T2-weighted image (C) (2500/105/1) shows corresponding high signal intensity within the genu of the corpus callosum (curved arrow), crossing the midline. An old infarct is noted within the right posterior border zone and scattered foci of T2 signal abnormality are seen in the left frontal and parietal regions. A biopsy of the lesion was obtained, confirming an infarct

View larger version (144K): [in a new window]   FIG 2. Case 2. Postcontrast axial T1-weighted image (A) (500/20/1) shows subtle enhancement with surrounding hypointensity within the genu of the corpus callosum (arrows). FLAIR images (B, C) (8900/140/1) show abnormal increased signal within both sides of the genu and body of the corpus callosum. Axial FLAIR images (D, E) (8900/140/1) from follow-up MR imaging performed 3 weeks later showed almost complete resolution of the abnormal signal within the corpus callosum

View larger version (66K): [in a new window]   FIG 3. Case 3. Sagittal precontrast T1-weighted image (A) (400/12/2) shows a hypointense ovoid mass (arrow) within the body of the corpus callosum, depressing the roof of the lateral ventricle. After administration of contrast material (B) (400/12/2), it enhances homogeneously. A small infarct (white arrow) is noted within the right thalamus on the axial T2-weighted image (C) (2560/90/1). Subsequent biopsy confirmed an infarct

View larger version (192K): [in a new window]   FIG 4. Case 4. Sagittal non-contrast T1- (A) (400/10/1) and coronal T2-weighted (B) (2500/105/1) images show abnormal signal within the body of the corpus callosum and adjacent white matter (arrow) on the left side. Sagittal (C) (400/8/2) and coronal (D) (450/20/1) postcontrast T1-weighted images from a subsequent MR examination show abnormal enhancement (arrow) within the corpus callosum and adjacent white matter