Callosal disconnection syndrome after corpus callosum infarct: a diffusion tensor tractography study

Area of Science:

• Neuroimaging
• Neurology
• Neuroanatomy

Background:

• Callosal disconnection syndrome (CDS) encompasses a range of neurological deficits resulting from damage to the corpus callosum (CC).
• Diffusion tensor tractography (DTT) is an advanced neuroimaging technique used to visualize white matter tracts in the brain.

Observation:

• A 72-year-old female patient presented with symptoms of CDS, including alien hand syndrome, agraphia, hemiparesis, somatosensory deficits, neglect, and visual recognition impairment.
• The patient had experienced an infarct affecting the corpus callosum.

Findings:

• DTT demonstrated extensive disruption of CC fibers in the patient, correlating with her clinical presentation.
• Specifically, CC fibers in the anterior genu and posterior splenium remained largely intact, while other pathways showed significant disconnection.
• Comparison with DTT from healthy subjects revealed normal bilateral fiber extensions to various cortical regions.

Implications:

• The findings suggest that DTT is a valuable tool for identifying corpus callosum lesions and understanding the neuroanatomical basis of CDS.
• This imaging modality can help elucidate the relationship between specific fiber tract damage and the diverse clinical manifestations of CDS.
• Accurate detection of CC lesions using DTT can potentially guide clinical diagnosis and management strategies for patients with disconnection syndromes.