Mechanism of Injury to the Corpus Callosum, With Particular Reference to the Anatomical Relationship Between Site of Injury and Adjacent Brain Structures

Shiramizu, Hideki; Masuko, Akihiko; Ishizaka, Hideo; Shibata, Masayoshi; Aoki, Hideki; Imai, Masaaki; Osada, Takahiro; Mizokami, Yoshihito; Baba, Tetsuya; Matsumae, Mitsunori

doi:10.2176/nmc.48.1

Cited by 27 publications

(30 citation statements)

References 16 publications

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“…9 The posterior region, or splenium, of the CC is especially vulnerable to TBI 10,11,12,13 Atrophy of the splenium of the CC has been observed following TBI. 14,15,16 Lesions in the posterior half of the CC accounted for 80% of all CC injuries in a study of 92 patients (i.e., ages 2-77, mean age 28) with severe TBI. 15 These lesions are thought to be a direct result of the injury including DAI, of secondary injuries, or of impaired or arrested CC development post injury.…”

Section: Event-related Potential Measure Of Interhemispheric Transfermentioning

confidence: 99%

“…14,15,16 Lesions in the posterior half of the CC accounted for 80% of all CC injuries in a study of 92 patients (i.e., ages 2-77, mean age 28) with severe TBI. 15 These lesions are thought to be a direct result of the injury including DAI, of secondary injuries, or of impaired or arrested CC development post injury. 15 The anterior CC is also vulnerable to secondary injury mechanisms following TBI such as elevated intracranial pressure, 17 although this finding is less established in the literature.…”

Section: Event-related Potential Measure Of Interhemispheric Transfermentioning

confidence: 99%

“…15 These lesions are thought to be a direct result of the injury including DAI, of secondary injuries, or of impaired or arrested CC development post injury. 15 The anterior CC is also vulnerable to secondary injury mechanisms following TBI such as elevated intracranial pressure, 17 although this finding is less established in the literature. In children with severe TBI, increased intracranial pressure immediately following TBI was correlated with reduced anterior CC size and overall white matter loss five years post TBI.…”

Section: Event-related Potential Measure Of Interhemispheric Transfermentioning

confidence: 99%

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The UCLA Study of Children with Moderate-to-Severe Traumatic Brain Injury: Event-Related Potential Measure of Interhemispheric Transfer Time

Ellis

Marion

McArthur

et al. 2016

Journal of Neurotrauma

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Traumatic brain injury (TBI) frequently results in diffuse axonal injury and other white matter damage. The corpus callosum (CC) is particularly vulnerable to injury following TBI. Damage to this white matter tract has been associated with impaired neurocognitive functioning in children with TBI. Event-Related Potentials can identify stimulus-locked neural activity with high temporal resolution. They were used in this study to measure interhemispheric transfer time (IHTT) as an indicator of CC integrity in 44 children with moderate/severe TBI at 3-5 months post-injury compared with 39 healthy control children. Neurocognitive performance was also examined in these groups. Nearly half of the children with TBI had IHTTs that were outside the range of the healthy control group children. This subgroup of TBI children with slow IHTT also had significantly poorer neurocognitive functioning than healthy controls-even after correction for premorbid intellectual functioning. We discuss alternative models for the relationship between IHTT and neurocognitive functioning following TBI. Slow IHTT may be a biomarker that identifies children at risk for poor cognitive functioning following moderate/severe TBI.

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Section: Event-related Potential Measure Of Interhemispheric Transfermentioning

confidence: 99%

Section: Event-related Potential Measure Of Interhemispheric Transfermentioning

confidence: 99%

Section: Event-related Potential Measure Of Interhemispheric Transfermentioning

confidence: 99%

See 1 more Smart Citation

The UCLA Study of Children with Moderate-to-Severe Traumatic Brain Injury: Event-Related Potential Measure of Interhemispheric Transfer Time

Ellis

Marion

McArthur

et al. 2016

Journal of Neurotrauma

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“…CC atrophy may be due to (1) the direct effect of the primary injury, (2) the effect of impaired cerebral perfusion at the time of critical illness, (3) impaired development during subsequent recovery, or (4) any combination of these mechanisms. At the time of injury, acceleration or deceleration may cause direct damage to the CC, particularly when there is oblique or lateral acceleration [13]. The hierarchy of vulnerability within the CC is in the rostral-to-caudal direction, with lesions in the posterior half occurring in 80% of such cases.…”

Section: Introductionmentioning

confidence: 99%

“…The posterior half of the falx is closer to the CC than the anterior half. Hence, the anterior portion can be displaced with lateral movement of the cerebral hemispheres, but movement of the posterior portion is limited, thereby putting it at risk of mechanical strain [13,14]. In contrast, if raised intracranial pressure (ICP) has been a significant factor during intensive care shortly after injury, then the distribution of CC vulnerability in chronic TBI is different [15].…”

Section: Introductionmentioning

confidence: 99%

Corpus Callosum and Inferior Forebrain White Matter Microstructure Are Related to Functional Outcome from Raised Intracranial Pressure in Child Traumatic Brain Injury

Tasker¹,

Westland²,

White

et al. 2010

Dev Neurosci

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In severe paediatric traumatic brain injury (TBI), a common focus of treatment is raised intracranial pressure (ICP). We have previously reported frontal cerebral vulnerability with executive deficits from raised ICP in paediatric TBI. Now, using diffusion tensor imaging (DTI) in a different population, we have examined fractional anisotropy (FA), and mean, axial and radial diffusivity (MD, AD, RD) in 4 regions of the corpus callosum (CC) and in both inferior frontal regions. Our aim was to examine during the chronic phase of TBI whether the CC cross-sectional area correlated with regional DTI metrics of white matter microstructure, with global outcome ratings of function (Functional Independence Measure and Multiattribute Health Status Classification) and with performance in the Rey-Osterrieth Complex Figure (ROCF) test. We examined 33 paediatric TBI cases who were followed, on average, 4.9 years after severe injury. All cases had received mechanical ventilation during their acute treatment and, a priori, they were assigned to a non-ICP or a raised ICP group. Twenty-two participants had mainly right-sided injury at the time of acute ictus. The findings confirm that severe TBI in childhood, complicated by intracranial hypertension, results in CC vulnerability. In the chronic phase of recovery, it is reduced in the cross-sectional area, it is more compact and thinned, and the anterior region is disproportionately small. Late after raised ICP, we have also found that individuals exhibit regional microstructural abnormality with combined reduced FA and increased MD, AD and RD. Smaller size and such microstructural changes in the anterior CC were associated with similar right-sided (rather than left-sided) frontal microstructural changes in the ICP group. Taken together, this evidence points to an interaction between raised ICP-related brain tissue perturbation and focal frontal extracallosal injury, leading to anterior CC regional vulnerability, most likely wallerian degeneration. At long-term follow-up, this lack of white matter integrity in the anterior CC is correlated with functional outcome, particularly in aspects of social interaction and the copy component of the ROCF test, which suggests that the CC-to-forebrain function warrants further study in chronic TBI.

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The splenium of the corpus callosum: embryology, anatomy, function and imaging with pathophysiological hypothesis

Blaauw

Meiners

2020

Neuroradiology

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Background and purpose The splenium of the corpus callosum is the most posterior part of the corpus callosum. Its embryological development, anatomy, vascularization, function, imaging of pathology, possible pathophysiological mechanisms by which pathology may develop and the clinical consequences are discussed. Methods A literature-based description is provided on development, anatomy and function. MR and CT images are used to demonstrate pathology. The majority of pathology, known to affect the splenium, and the clinical effects are described in three subsections: (A) limited to the splenium, with elaboration on pathophysiology of reversible splenial lesions, (B) pathology in the cerebral white matter extending into or deriving from the splenium, with special emphasis on tumors, and (C) splenial involvement in generalized conditions affecting the entire brain, with a hypothesis for pathophysiological mechanisms for the different diseases.Results The development of the splenium is preceded by the formation of the hippocampal commissure. It is bordered by the falx and the tentorium and is perfused by the anterior and posterior circulation. It contains different caliber axonal fibers and the most compact area of callosal glial cells. These findings may explain the affinity of specific forms of pathology for this region. The fibers interconnect the temporal and occipital regions of both hemispheres reciprocally and are important in language, visuospatial information transfer and behavior. Acquired pathology may lead to changes in consciousness. Conclusion The development, location, fiber composition and vascularization of the splenium make it vulnerable to specific pathological processes. It appears to play an important role in consciousness. AbbreviationAC anterior commissure ACC agenesis of the corpus callosum ADEM acute disseminated encephalomyelitis ADH anti-diuretic hormone AED anti-epileptic drugs AVP arginine-vasopressin CC corpus callosum CLOCC cytotoxic lesions of the corpus callosum DLBCL diffuse large B cell lymphoma GBM glioblastoma multiforme HC hippocampal commissure HIE hypoxic ischemic encephalopathy MERS mild encephalitis/encephalopathy with a reversible splenial lesion PCNSL primary central nervous system lymphoma RESLES reversible splenial lesions syndrome

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Mechanism of Injury to the Corpus Callosum, With Particular Reference to the Anatomical Relationship Between Site of Injury and Adjacent Brain Structures

Cited by 27 publications

References 16 publications

The UCLA Study of Children with Moderate-to-Severe Traumatic Brain Injury: Event-Related Potential Measure of Interhemispheric Transfer Time

The UCLA Study of Children with Moderate-to-Severe Traumatic Brain Injury: Event-Related Potential Measure of Interhemispheric Transfer Time

Corpus Callosum and Inferior Forebrain White Matter Microstructure Are Related to Functional Outcome from Raised Intracranial Pressure in Child Traumatic Brain Injury

The splenium of the corpus callosum: embryology, anatomy, function and imaging with pathophysiological hypothesis

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