Corpus Callosum Infarction-MRI

An elderly hypertensive male presents with gait apraxia  and MRI with MRA show

·         An ill-defined restricted diffusion focus  with no bleed or  significant mass effect or herniation or shift of midline in the anterior corpus callosum  suggesting recent onset non-hemorrhagic infarction.

·         MRA suggests  atherogenic focus   in the pericallosal branch of ACA suggesting the etiology is local and  unlikely to be cardiogenic embolism

Teaching points by Dr MGK Murthy, Dr Preeti Saxena

·         Callosal infarctions are uncommon because  of rich vascular supply form the 3 vessels namely ACA, ACom and Posterior cerebrals (PCA)

·         Pericallosal branch  of ACA is the main supply for body

·         Subcallosal and medial callosal  vessels from A.Com  (hence ACA supplies  a total of 4/5ths of callosum) are  mainly responsible for anterior portion

·         Posteror pericallosal  from  PCA  supplies splenium

·         Individual   Variations are common from the above  typical  distribution

·         Symptoms can vary  and can be silent/ transient weakness/ speech disturbance / alien hand syndrome/ gait apraxia  etc

·         Splenium is more commonly involved as PCA infarctions are more frequent than ACA