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Related Experiment Video

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Comprehensive Autopsy Program for Individuals with Multiple Sclerosis

Comprehensive Autopsy Program for Individuals with Multiple Sclerosis

Published on: July 19, 2019

Tumefactive demyelination-to cracks the nut without cracking the pot.

C Rajasekharan¹, V Anto, R Unnikrishnan

¹Department of Internal Medicine, Medical College Hospital, Thiruvanthapuram, Kerala, India. drcrajasekharan@yahoo.com

BMJ Case Reports

|May 19, 2012

Summary

A rare brain lesion in the corpus callosum, initially suspected as glioma or lymphoma, responded dramatically to steroid treatment in a diabetic patient. This case highlights steroids as a potential treatment for certain corpus callosum lesions.

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Area of Science:

Neuroscience
Radiology
Oncology

Background:

The corpus callosum is crucial for interhemispheric communication.
Lesions in this area can cause diverse and severe neurological deficits.
Differential diagnosis for corpus callosum lesions includes tumors, inflammatory conditions, and infections.

Observation:

A 45-year-old diabetic female presented with progressive gait difficulty, cognitive changes, and incontinence.
Clinical examination revealed facial nerve palsy and ataxia.
Brain imaging showed a hyperdense lesion in the corpus callosum, with MRI revealing T2-hyperintense lesions with restricted diffusion.

Findings:

Initial differential diagnoses included infiltrative glioma, demyelination, and CNS lymphoma.
Due to patient and family refusal of biopsy, empiric steroid treatment was initiated.
Neurological deficits resolved, and repeat MRI demonstrated significant lesion reduction, suggesting a steroid-responsive etiology.

Implications:

This case suggests that steroid-responsive inflammatory or demyelinating processes should be considered in the differential diagnosis of corpus callosum lesions, even with initial imaging suggestive of malignancy.
Prompt diagnosis and treatment, even without biopsy, can lead to significant recovery.
Further research into non-invasive diagnostic methods and treatment protocols for corpus callosum lesions is warranted.