Infarction of the Splenium of the Corpus Callosum in the Age of COVID-19: A Snapshot in Time

Stroke. 2020 Sep;51(9):e223-e226. doi: 10.1161/STROKEAHA.120.030434. Epub 2020 Jul 20.

Abstract

Background and purpose: Ischemic infarction of the corpus callosum is rare and infarction isolated to the corpus callosum alone rarer still, accounting for much <1% of ischemic stroke in most stroke registries. About half of callosal infarctions affect the splenium.

Methods: During a 2-week period, at the height of the coronavirus disease 2019 (COVID-19) pandemic in New York City, 4 patients at Montefiore Medical Center in the Bronx were found to have ischemic lesions of the splenium of the corpus callosum, 2 with infarction isolated to the corpus callosum.

Results: All patients tested positive for COVID-19 and 3 had prolonged periods of intubation. All had cardiovascular risk factors. Clinically, all presented with encephalopathy and had evidence of coagulopathy and raised inflammatory markers.

Conclusions: Infarction of the splenium of the corpus callosum is exceedingly rare and a cluster of such cases suggests COVID-19 as an inciting agent, with the mechanisms to be elucidated.

Keywords: COVID-19; coronavirus; corpus callosum; inpatients; posterior cerebral artery.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aged, 80 and over
  • Brain Ischemia / complications
  • Brain Ischemia / pathology
  • COVID-19
  • Cerebral Infarction / complications*
  • Cerebral Infarction / pathology*
  • Coronavirus Infections / complications*
  • Corpus Callosum / pathology*
  • Diabetes Complications / complications
  • Fatal Outcome
  • Female
  • Humans
  • Hypertension / complications
  • Hypothyroidism / complications
  • Inflammation / blood
  • Intubation, Intratracheal
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / complications*
  • Risk Factors
  • Stroke / etiology
  • Stroke / pathology
  • Stroke Rehabilitation