Clinical And Radiologic Analysis Of Acute Corpus Callosum Infarction

Objective: To explore incidence,etiology,risk factors,clinical and imaging characteristics,prognosis of acute corpus callosum infarction,improve the awareness and diagnostic level of the disease,avoid misdiagnosis and missed diagnosis,improve the prognosis.Methods: From January 1,2012 to December 31,2016,clinical and imaging data of 127 patients with acute corpus callosum infarction in the department of neurology were retrospectively analyzed.All patients were further divided into pure corpus callosum infarction and complex corpus callosum infarction,the clinical and imaging features of two groups were analyzed.At the same time,the clinical and imaging data of 53 patients with basal ganglia infarction were collected randomly,compared with pure corpus callosum infarction,and analysis the clinical and imaging features of the two groups.Results: The incidence of acute corpus callosum infarction accounted for 2.27% of the cerebral infarction at the same period.The average age of patients with acute corpus callosum infarction was 64.89±12.61 years old,visit hospital for a long time,an average of 61.31 hours.The main risk factors were hypertension(74.0%),diabetes(40.2%),hyperlipidemia(45.0%)and smoking(37.8%).The most common clinical manifestations were hemiplegia(73.2%),central facial paralysis(38.6%),cognitive impairment(26%),mental / emotional abnormality(21.3%),and paresthesia(20.5%).106 patients with complex corpus callosum infarction and 21 patients with pure corpus callosum infarction were found by imaging examination in these patients.The most susceptible location was the splenium(52,40.9%),followed by genu(27,21.3%)and body(8,6.3%),40 patients presented infarctions in two or more locations.Evaluation of cerebral vessels showed that most of the patients with corpus callosum infarction had intracranial artery stenosis or occlusion,and nearly half of the patients with three or more vascular stenosis.The incidence of acute pure corpus callosum infarction accounted for 0.38% of the cerebral infarction at the same period.The average age of patients with acute pure corpus callosum infarction was 63.29±9.18 years old,the average of visit time was 155.3 hours.The main risk factors of pure corpus callosum infarction were hypertension(71.4%),diabetes(57.1%),history of large-artery atherosclerosis(47.6%),smoking(38.1%)and hyperlipidemia(36.8%).The most common clinical manifestations were hemiplegia(57.1%),mental / emotional abnormality(38.1%),central facial paralysis(33.3%),cognitive impairment(28.6%).Evaluation of cerebral vessels showed that most of the patients with pure corpus callosum infarction had intracranial artery stenosis or occlusion,and more than half of the patients with three or more vascular stenosis.Compared with the most common basal ganglia infarction,the patients with pure corpus callosum infarction had longer visit time(p<0.05)and more risk factors(p<0.05),and these patients were significantly more likely to suffer from diabetes and history of stroke(p<0.05).In clinical manifestation,patients with basal ganglia infarction were significantly more likely to suffer from hemiplegia,central facial paralysis and paresthesia.Conversely,the patients with pure corpus callosum infarction were significantly more likely to suffer from cognitive impairment and mental / emotional abnormality.In patients with pure corpus callosum infarction,the number of paralyzed limbs was less,and the muscle strength was better.Compared with the most common basal ganglia infarction,the patients with pure corpus callosum infarction had more intracranial artery stenosis.Furthermore,there were statistically significant differences in anterior cerebral artery,posterior cerebral artery and basilar artery.The recurrence rate of cerebral infarction in patients with pure corpus callosum infarction was significantly higher than that in patients with basal ganglia infarction after 1 years.Conclusion: The incidence of corpus callosum infarction is low,which is mainly in middle-aged and elderly people with risk factors of cerebrovascular disease,and most of these patients presented with additional lesions apart from the corpus callosum.The clinical manifestation of corpus callosum infarction is complex and changeable,the visit time is long,and the thrombolysis rate is low.The specific clinical manifestations of the disease are cognitive impairment and mental / emotional abnormality.Patients with corpus callosum infarction often have multiple intracranial artery stenosis or occlusion.The most common cause of corpus callosum infarction was atherosclerosis.The risk of recurrent cerebral infarction in patients with corpus callosum infarction is high,and the prevention and followup of the disease should be strengthened to improve the prognosis.