Disclosures: Arline Edmond, MD: Nothing to disclose

Case Description: Corpus callosum infarction.

Setting: Hospital and Acute Rehabilitation.

Patient: A 52-year-old man presented after being assaulted and sustaining a traumatic brain injury. Imaging of the head showed right subdural hematoma and he underwent an emergent craniotomy. As his level of consciousness improved, he exhibited right sided hemiparesis and dysarthria not consistent with the location of his injury.

Assessment/Results: Diffusion weighted magnetic resonance imaging showed an isolated diffusion restricted region in the posterior body and splenium of the corpus callosum (CC) consistent with an acute infarction. He was ultimately discharged to acute rehabilitation where he completed 3 weeks of therapy with mild improvement in his right sided hemiparesis and dysarthria. After bracing with an ankle foot orthosis, he was able to walk community distances at supervision level and was discharged home.

Discussion: The CC is a centrally located structure composed of axonal fibers connecting the two cerebral hemispheres that is essential for the interhemispheric transfer of motor, cognitive, and sensory information. The CC has a dual blood supply from both the anterior and posterior cerebral arteries, making infarctions of the CC very uncommon with a reported incidence of 0.43%. CC infarctions are classically associated with disconnection syndromes including alien hand syndrome and alexia without agraphia. Less common manifestations of isolated CC infarctions are hemiparesis, dysarthria, confusion, headaches, sensory changes, and ataxia. If a patient’s imaging does not correlate with an infarction, additional work up should be undertaken to determine the etiology of the CC lesion such as malignancy, demyelinating disease, or diffuse axonal injury.

Conclusion: Physiatrists should be aware of this uncommon presentation of hemiparesis and dysarthria after isolated CC infarction. Increased awareness of the clinical spectrum of CC infarctions can prevent unnecessary diagnostic workup in these patients. Additional retrospective studies are needed to characterize isolated CC infarctions including risk factors, clinical manifestations, and prognosis.

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/isolated-infarction-of-the-corpus-callosum-a-case-report-of-an-uncommon-cause-of-hemiparesis-and-dysarthria/