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Reversible splenial lesion on the corpus callosum in nonfulminant hepatitis A presenting as encephalopathy

Soon Young Ko1, Byung Kook Kim1, Dong Wook Kim2

  • 1Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.

Clinical and Molecular Hepatology
|December 31, 2014
PubMed

Insights

Mild encephalitis/encephalopathy can cause reversible brain lesions. This case shows a reversible splenium of the corpus callosum lesion linked to nonfulminant hepatitis A, resolving with patient recovery.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Radiology

Background:

  • Reversible focal lesions on the splenium of the corpus callosum (SCC) are associated with various infectious agents causing mild encephalitis/encephalopathy.
  • Hepatitis A virus (HAV) infection is a potential, though less common, cause of neurological complications.

Observation:

  • A 30-year-old male presented with dysarthria and fever, progressing to confusion.
  • Brain MRI revealed a diffusion-weighted imaging (DWI) hyperintensity specifically in the SCC.
  • Electroencephalography (EEG) was performed concurrently with MRI.

Findings:

  • The patient experienced neurological improvement within 5 days of admission.
  • The SCC lesion identified on MRI completely resolved by day 15.
  • The findings suggest a direct link between nonfulminant hepatitis A and reversible SCC lesions causing encephalopathy.

Implications:

  • This case expands the spectrum of neurological manifestations of hepatitis A.
  • Highlights the importance of considering infectious etiologies, including hepatitis A, in cases of reversible SCC lesions and encephalopathy.
  • Suggests that MRI, particularly DWI, is crucial for diagnosing these reversible neurological changes.
Keywords:
Acute hepatitis ACorpus callosumEncephalopathyMagnetic resonance imaging

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