splenium hyperintensity
DESCRIPTION
FLAIR MRI differentials for splenial hyperintensities.TRANSCRIPT
Neuro Radio MeetDr. Mitusha Verma
Case 1
16 year Male patient with history of fall from train on 04.09.13,unconcious since then.
CT SCAN (outside)
MRI(14.09.13)
Axial FLAIR
Axial FLAIR
Axial FLAIR
Axial T2W
Axial Diffusion Axial Diffusion
Axial Diffusion
Axial GRE
Coronal FLAIR
Large , ill defined lesion hyperintense on Flair and T2W images in body and splenium. These areas show restricted diffusion. Foci of hemorrhage also seen
Similar lesions seen in Right superior frontal parenchyma, bilateral inferomedial temporal parenchyma,right middle cerebellar peduncle,left superior cerebellum,left pons,left crus mid-brain.
These findings are suggestive of Diffuse axonal injuries.
Small subdural hematoma over right parieto-occipital convexity.
A depressed fracture of the right frontal bone is seen.
CASE 2…
47 yr , Male admitted with – fever with chills since 2 days 1 episode of ? Convulsions Bleeding from mouth. Patient is a known chronic alcohalic
Investigations
10.09.13 – Dengue NS1Ag +ve 11.09.13 – Disoriented EEG- Excess of slow activity on both
sides. 12.09.13- Platelets- 23000 12.09.13- MRI
Axial Diffusion Axial T2W
MR scan reveals, a small area of restricted diffusion in splenium of corpus callosum.
This finding is not specific and has been described in postictal edema, diffuse axonal injury, infective causes like dengue and influenza.
Clinical correlation is recommended.
Discussion…
Clinical conditions associated with Transient Splenial Hyper intensity
Epilepsy
Infection
Demylination
Metabolic
VascularMiscellaneou
s
SeizuresAnti-Epileptic OverdoseAbrupt Drug WithdrawlEncephalitisSalmonellaMalariaRota Virus
Acute disseminates EncephalomylitisSLE.Cerebro vascular diseasePost cardiac arrestPre eclamsiaPosterior reversible encephalopathy syndromeHypertensive encephalopathyMigraine with aura
Vitamin B12 deficiencyDrug toxicityHigh altitudinal cerebral edemaTrauma- axonal injuryPost RadiationLymphomas
HypoglycemiaHypo/Hyper NaRenal Failure Marchiafava-Bignami disease
Refractory Epilepsy – Boomerang sign
Epilepsy with SOL – Boomerang sign
Migraine pain
T H A N K Y O U…