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Callosal warning syndrome.

Ramachandiran Nandhagopal1, Abdullah Al-Asmi, William James Johnston

  • 1Unit of Neurology, Department of Medicine, College of Medicine and Health Sciences, P.O. Box. 35, SQU, Al-Khod, Zip 123, Muscat, Oman. rnandagopal@yahoo.com

Journal of the Neurological Sciences
|November 15, 2011
PubMed
Summary
This summary is machine-generated.

A rare case of crescendo transient ischemic attacks (TIAs) led to corpus callosum infarction, a condition termed "callosal warning syndrome." This syndrome presents with fluctuating disconnection symptoms before a persistent stroke occurs.

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Area of Science:

  • Neurology
  • Neuroimaging
  • Vascular Neurology

Background:

  • Transient ischemic attacks (TIAs) are warning signs of impending stroke.
  • Corpus callosum ischemia is an uncommon cause of neurological deficits.
  • Disconnection syndromes manifest as specific functional impairments due to disrupted interhemispheric communication.

Observation:

  • A 40-year-old man presented with transient symptoms of corpus callosum disconnection, including intermanual conflict and left-hand apraxia.
  • Serial MRI scans revealed the ischemic nature of initial fluctuating symptoms and subsequent callosal infarction.
  • MRA showed no significant stenosis in major cerebral arteries supplying the corpus callosum.

Findings:

  • The patient experienced crescendo TIAs that ultimately resulted in a persistent infarction of the corpus callosum.
  • The clinical presentation and temporal profile were distinct, leading to the proposed term 'callosal warning syndrome'.
  • Despite standard stroke treatment, the patient had residual left-hand apraxia and dysgraphia at one-month follow-up.

Implications:

  • This case introduces a novel stroke syndrome, 'callosal warning syndrome,' characterized by TIAs preceding corpus callosum infarction.
  • Recognizing this pattern may improve early diagnosis and intervention for specific types of stroke.
  • Understanding callosal ischemia contributes to the broader knowledge of cerebrovascular disease and its varied presentations.