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AJNR Am J Neuroradiol. 2006 Oct;27(9):1983-6.

Transient splenial lesion of the corpus callosum in clinically mild influenza-associated encephalitis/encephalopathy.

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  • 1Department of Radiology, Gulhane Military Medical Academy, Ankara, Turkey.



Reversible lesions in the splenium of the corpus callosum (SCC), caused by various agents such as influenza, rotavirus, Escherichia coli, mumps, and adenovirus, were previously defined in a handful of cases. We present 5 cases with transient diffusion restriction of the SCC associated with influenza A virus infection.


Five patients with influenza-associated encephalitis/encephalopathy and sudden-onset neurologic symptoms following a prodromal flulike episode were examined by MR and diffusion-weighted imaging (DWI).


Three patients, who had drowsiness and new-onset convulsions, recovered spontaneously without any medication. In the other 2 seizure-free patients, 1 had trigeminal neuralgia and headache and the other had facial numbness and left upper monoparesis. All patients had round well-defined ovoid hyperintense splenial lesions (14.94 +/- 1.87 mm) on DWI with a significantly low apparent diffusion coefficient (ADC) of 0.41 +/- 0.05 x 10(-3) mm(2)/s compared with 0.84 +/- 0.01 x 10(-3) mm(2)/s of normal-appearing white matter. In the patient with a motor deficit, additional lesions were found in the cerebral deep white matter. The high signal intensity of the splenial and deep white matter lesions on DWI completely disappeared on follow-up studies, and ADC values also improved, returning to those of normal-appearing white matter on days 8-11. Clinically, all patients completely recovered on days 4-9.


A transient lesion of the SCC is a significant but nonspecific finding. It is probably due to edematous and/or inflammatory changes of the SCC. It may be the only detectable change in patients with good prognosis, indicating a clinically mild form of encephalitis/encephalopathy.

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