Diffusion-Restricted Lesions of the Splenium: Clinical Presentation, Radiographic Patterns, and Patient Outcomes

Area of Science:

• Neurology
• Radiology
• Neuroimaging

Background:

• Diffusion-restricted (DR) lesions of the splenium are observed across various pathologies with unclear significance.
• Understanding their clinical presentation and imaging patterns is crucial for diagnosis and management.

Purpose of the Study:

• To characterize the spectrum of clinical presentations and neuroimaging patterns of DR splenial lesions.
• To identify predictors of radiographic and clinical outcomes in patients with DR splenial lesions.

Main Methods:

• Retrospective cohort study of 3,490 brain MRI scans (Jan 2009-Aug 2020).
• Included 200 patients with DR lesions in the corpus callosum, excluding specific conditions.
• Assessed clinical and radiologic outcomes, including readmissions and mortality.

Main Results:

• Vascular causes (61%) were most frequent for DR splenial lesions.
• Encephalopathy was linked to in-hospital mortality (OR: 4.50).
• Mass effect negatively impacted DR resolution (OR: 0.12), while CLOCCs were associated with fewer readmissions.

Conclusions:

• DR splenial lesions, particularly vascular ones, are common.
• Clinical and radiographic features can predict outcomes, aiding in patient prognosis.
• Further research into these challenging lesions is warranted.