Transient lesion of the splenium

Case contributed by Emtenan Meer
Diagnosis probable

Presentation

Headache, fever, photophobia, and an unsteady gait. He declined to have a lumbar puncture.

Patient Data

Age: 20 years
Gender: Male

The splenium of the corpus callosum shows a focal area of high T2, low T1 signal intensity with restricted diffusion and no enhancement on postcontrast images. This lesion measures 1.4 x 0.6 cm and shows no surrounding edema.

An incidental DVA is noted at the right frontal lobe.

Subtle ill-defined hypodensity at the splenium of the corpus callosum is present. 

Case Discussion

Transient lesion of the central splenium is associated with multiple variable etiologies, including epilepsy, antiepileptic drugs, infections, and metabolic disturbances. Sometimes this is the only finding seen in symptomatic patients and so its presence is essential to confirm the diagnosis of mild encephalitis/encephalopathy.

This patient lost follow-up and further evaluation was not done.

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