Clinical Analysis Of 152 Patients With Corpus Callosum Lesions

Objective Through analyzing the etiology?clinical features and imaging findings of corpus callosum(CC),in order to improve the clinical doctor's understanding of CC lesions.Methods The clinical data of 152 patients with CC lesions who were hospitalized in the General Hospital of NingXia Medical University from January2017 to March 2018 were retrospectively analyzed.The demographic data,high risk factors,clinical features,laboratory tests and imaging were collected,the causes were analyzed and the clinical and imaging characteristics were summarized according to different causes.Firstly,patients with a single site of the CC lesions were divided into three groups according to the lesions: genu,body and splenium.The clinical characteristics of the three groups were compared.Secondly,the CC lesions were divided into two groups according to the lesions: only CC lesions and CC lesions with other areas of the brain.The etiology,clinical and imaging features of the two groups were compared.Finally,the CC lesions were divided into two groups according to the cause: vascular disease and non-vascular disease,and the risk factors,clinical and imaging characteristics of the two groups were compared.Results After analying the clinical data of CC lesions,summarized that:(1)The CC lesions were more common in men,and the average age was 50.(2)The common clinical features of CC were conscious disturbance(36.8%),dizziness(35.5%),dyskinesia(35.5%),headache(34.9%),nausea/vomiting(27.6%)and cognitive impairment(16.4%).(3)The lesions of the CC were more common in a single site(77.6%),and the most common site was the splenium(38.8%).The clinical data of CC lesions with different causes showed that :(1)The etiology of CC lesions was diverse,the most common causes were the infarction in 59cases(38.8%),trauma in 29 cases(19.1%)and neoplasms in 25 cases(16.4%),other causes were infectious and immunological diseases(9.2%),toxicity and metabolic(5.9%),hemorrhage(5.3%),congenital diseases(3.3%)and unexplained diseases(2.0%).(2)Congenital diseases(100%)?toxicity and metabolic diseases(55.6%)were more common in multiple lesions of the CC.Neoplasms were most common in the genu of CC(44.0%).Hemorrhage(50.0%)and trauma(37.9%)were most common in the body of CC.Infection and immunity(85.7%)?infarction(52.5%)were most common in splenium of CC.(3)(1)According to the CISS classification,the most common form of CC ischemic disease was aortic atherosclerosis(44.1%).(2)From the etiology,arteriovenous malformation and aneurysm were the main causes of hemorrhage in CC.Hematoma often breaks into the subarachnoid space or ventricle(87.5%).(3)The main clinical manifestation of traumatic disease of CC were consciousness dysfunction(89.7%).(4)In addition,only one patient who was hospitalized for pulmonary infection showed mental behavior abnormalities in the infectious and immunological CC lesions,furthermore the MRI showed the single splenium of CC lesions and that the focus disappeard in the follow-up.According to the analysis of clinical data of CC lesions in different groups:(1)The clinical characteristics of lesions in different parts of CC were compared: The dyskinesia occurred mostly in the body of the CC(P<0.05),and the apathy/sluggishness occurred mostly in the genu of CC(P<0.05);ataxia and hemianopia occurred only in the splenium,but there is no statistically significant.(2)Compared clinical features between the two groups with only CC lesions and CC lesions with other areas of the brain:(1)21 patients(13.8%)with only CC lesions,the most common cause were ischemic(33.3%)?infection and immunity(28.6%),therewere differences in the etiology of the two groups(P <0.05),infectious and immune diseases often occurred in the only CC lesions.(2)The splenium was the most common site of the only CC lesions(61.9%).There were differences in the composition of the lesions between the two groups(P<0.05).The genu lesions mostly occurred in the CC lesions with other areas of the brain group,and the splenium lesions mostly occurred in the only CC lesions.(3)Compared the clinical features between vascular and non-vascular CC diseases:(1)67 cases of vascular CC diseases(44.1%),the average age was 59 which was larger than non-vascular group(P<0.01),hypertension,diabetes,hyperlipidemia,hyperhomocysteinemia,cerebrovascular disease,heart disease and overweight were more likely to be seen in the vascular disease(P<0.01).(2)Dizziness,dysarthria / aphasia,sensory disturbance,dyskinesia and facial paralysis were more common in the vascular disease(P <0.05),but headache symptoms were more common in the non-vascular disease(P <0.05).(3)From the characteristics of imaging,multiple lesions of CC was more common in non-vascular diseases(P <0.05),and the splenium lesions of CC mostly occurred in vascular diseases(P <0.05).Conclusions 1.The CC lesions were more common in males.The common clinical symptoms were disturbance of consciousness,dizziness and movement disorder.The lesion was often seen in a single part of the CC,most commonly in the splenium.2.The causes of CC lesions were diverse,the main causes were infarction,trauma and neoplasms.The clinical features,lesions and imaging features of different causes had their own characteristics.3.The dyskinesia mostly occurred in the body,and the apathy/sluggishness mostly occurred in the genu;the splenium lesions mostly occurred in only CC lesions group,and the genu lesions mostly occurred in the CC lesions with other areas of the brain group;multiple lesions of CC was more common in non-vascular diseases.4.It's necessary to consider about extracranial lesions for patients with CC damage of unclear etiology.