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Corpus Callosal Signal Changes in Patients with Obstructive Hydrocephalus after Ventriculoperitoneal Shunting

John I. Lanea, Patrick H. Luetmera and John L. AtkinsonGo,a

a From the Departments of Radiology (J.I.L., P.H.L.) and Neurosurgery (J.L.A.), Mayo Clinic, Rochester, MN.



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  		FIG 1. Iatrogenic callosal injury. Axial proton density–weighted (2200/20/1) image shows small horizontal cleft of increased signal within the body of the corpus callosum (arrow) adjacent to the shunt catheter that is probably related to direct trauma sustained during catheter placement



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  		FIG 2. Case 7: callosal injury from long-standing obstructive hydrocephalus.

A, Sagittal T1-weighted (500/15/2) image obtained before shunt placement shows marked upward displacement of the corpus callosum (straight arrows). Note fourth ventricular mass (curved arrow) extending into and obstructing the aqueduct.

B, Sagittal T1-weighted (500/20/2) image obtained 3 months after ventricular shunting shows diffuse areas of decreased signal within the body of the corpus callosum (arrows), which is likely the result of compression against the falx.

C and D, Axial proton density– (C) and T2-weighted (D) (2200/20,80/1) images show increased signal within the body of the corpus callosum (arrows), corresponding to abnormalities in the sagittal plane.



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  		FIG 3. Case 2: callosal injury from long-standing obstructive hydrocephalus in a patient with aqueductal stenosis.

A, Sagittal T1-weighted (500/15/2) image obtained before shunt placement shows moderate upward displacement of the corpus callosum (arrows).

B, T1-weighted sagittal (500/15/2) image 5 months after ventricular shunting shows diffuse areas of decreased signal within the posterior body of the corpus callosum (arrows), which was most likely caused by compression against the falx.

C and D, Axial proton density– and T2-weighted (2200/20,80/1) images show increased signal within the body of the corpus callosum (arrows) corresponding to abnormalities in the sagittal plane.



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  		FIG 4. Case 1: callosal injury in a patient with obstructing tectal tumor. Postshunt sagittal FLAIR sequence (11002/148/1, TI = 2250) proved to be the most sensitive in detecting callosal signal changes but was not included in the imaging protocols of all examinations reviewed





Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X