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Acute Myocardial Infarction in Rats
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Does restricted diffusion in the splenium indicate an acute infarct?

Zeynep Ezgi Balcik1, Songül Senadim2, Aslı Keskek2

  • 1Department of Neurology, Bakirkoy Research and Training Hospital for Psychiatry, Neurology, Neurosurgery, Istanbul, 34147, Turkey. zeynepezgi33@hotmail.com.

Acta Neurologica Belgica
|January 8, 2018
PubMed
Summary

Splenium lesions on MRI can mimic ischemic stroke but may stem from various causes like infections or metabolic issues. Investigating a wide range of symptoms and etiologies is crucial for accurate diagnosis.

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Area of Science:

  • Neuroimaging
  • Neurology
  • Radiology

Background:

  • Splenium lesions are uncommon but associated with diverse conditions including ischemic infarcts, drug toxicity, encephalitis, and metabolic disturbances.
  • Accurate diagnosis of splenium lesions is critical due to their varied underlying pathologies.

Purpose of the Study:

  • To evaluate the clinical and imaging findings and determine the etiologies of splenium lesions in a cohort of 16 patients.

Main Methods:

  • Retrospective analysis of 16 patients with splenium lesions between 2013 and 2017.
  • Magnetic resonance imaging (MRI) including fluid attenuation inversion recovery (FLAIR), diffusion-weighted imaging (DWI), and apparent diffusion coefficient (ADC) mapping was performed.

Main Results:

  • The study included 11 males and 5 females (mean age 52.3 years) presenting with symptoms like consciousness disorder, headache, seizure, and hemiparesis.
  • MRI revealed splenium hyperintensity on DWI in all patients, with 87.5% showing hypointensity on ADC.
  • Identified etiologies included ischemic infarction (25%), tuberculous meningitis (18.7%), viral encephalitis (12.5%), and other less common causes.

Conclusions:

  • Diffuse restriction on MRI, particularly in the splenium, does not always indicate ischemic stroke.
  • Splenium lesions can result from various pathologies, necessitating a broad differential diagnosis beyond ischemic infarction.
  • Comprehensive evaluation of clinical symptoms and potential etiologies is essential for managing patients with splenium lesions.