open access

Vol 50, No 4 (2016)
Case reports
Submitted: 2016-01-23
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Acute infarction of corpus callosum due to transient obstructive hydrocephalus

Bahar Kaymakamzade, Amber Eker
DOI: 10.1016/j.pjnns.2016.03.005
·
Neurol Neurochir Pol 2016;50(4):280-283.

open access

Vol 50, No 4 (2016)
Case reports
Submitted: 2016-01-23

Abstract

Acute ischemia of the corpus callosum (CC) is not a well-known feature in patients with acute hydrocephalus. Herein, we describe a case with acute CC infarction due to another rare entity; transient obstructive hydrocephalus. A 66-year-old male was admitted with sudden onset right-sided hemiparesia. CT demonstrated a hematoma on the left basal ganglia with extension to all ventricles. The following day, the patient's neurological status progressed to coma and developed bilateral pyramidal signs. MRI demonstrated obstructive hydrocephalus and acute diffuse infarction accompanied by elevation of the CC. On the same day there was improvement in his neurological status with significant decrease in ventricular size and complete resolution of the clot in the third ventricle. The mechanism of signal abnormalities is probably related with the neural compression of the CC against the falx. Presumably, the clot causing obstruction in the third ventricle dissolved or decayed by the help of fibrinolytic activity of CSF, which was raised after IVH and caused spontaneous improvement of hydrocephalus. Bilateral neurological symptoms suggest diffuse axonal damage and normalization of the intracranial pressure should be performed on the early onset of clinical detorioration in order to prevent axonal injury.

Abstract

Acute ischemia of the corpus callosum (CC) is not a well-known feature in patients with acute hydrocephalus. Herein, we describe a case with acute CC infarction due to another rare entity; transient obstructive hydrocephalus. A 66-year-old male was admitted with sudden onset right-sided hemiparesia. CT demonstrated a hematoma on the left basal ganglia with extension to all ventricles. The following day, the patient's neurological status progressed to coma and developed bilateral pyramidal signs. MRI demonstrated obstructive hydrocephalus and acute diffuse infarction accompanied by elevation of the CC. On the same day there was improvement in his neurological status with significant decrease in ventricular size and complete resolution of the clot in the third ventricle. The mechanism of signal abnormalities is probably related with the neural compression of the CC against the falx. Presumably, the clot causing obstruction in the third ventricle dissolved or decayed by the help of fibrinolytic activity of CSF, which was raised after IVH and caused spontaneous improvement of hydrocephalus. Bilateral neurological symptoms suggest diffuse axonal damage and normalization of the intracranial pressure should be performed on the early onset of clinical detorioration in order to prevent axonal injury.

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Keywords

Corpus callosum, Hydrocephalus, Ischemia, Diffuse axonal injury

About this article
Title

Acute infarction of corpus callosum due to transient obstructive hydrocephalus

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 50, No 4 (2016)

Pages

280-283

DOI

10.1016/j.pjnns.2016.03.005

Bibliographic record

Neurol Neurochir Pol 2016;50(4):280-283.

Keywords

Corpus callosum
Hydrocephalus
Ischemia
Diffuse axonal injury

Authors

Bahar Kaymakamzade
Amber Eker

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