Annals of Rehabilitation Medicine

Intracranial Hemorrhage in the Corpus Callosum Presenting as Callosal Disconnection Syndrome: FDG-PET and Tractography: A Case Report: In Hwan Kim, Soyoung Lee, Chang-Young Lee, Dong Gyu Lee; Ann Rehabil Med 2014;38(6):871-875. Published online December 24, 2014; DOI: https://doi.org/10.5535/arm.2014.38.6.871

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We report the findings of ¹⁸F-fluorodeoxyglocese positron emission tomography (FDG-PET) and diffusion tensor tractography (DTT) in a right-handed patient presenting with callosal disconnection syndrome, including alien hand syndrome, after an anterior communicating artery aneurysmal rupture. The 49-year-old patient had right hemiparesis and unintended movement of the right hand during action of the left hand. A brain magnetic resonance imaging revealed lesions in the upper part of the genu and body in the corpus callosum as well as hemorrhage in the inter-hemispheric fissure. We observed extensive disruption of corpus callosum fibers in the upper genu and trunk by DTT for the evaluation of inter-hemispheric connection. FDG-PET revealed severe hypometabolism in the left cerebral hemisphere, including basal ganglia and thalamus, and hypermetabolism in the right cerebral hemisphere. Based on findings of FDG-PET and DTT, the callosal disconnection syndrome presented in the patient could be the result of loss of transcallosal inhibition in the contralateral hemisphere.

Citations

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Mirror-writing after Corpus Callosum Lesion Induced by Both Posterior Cerebral Artery Infarction: A case report.: Kim, Hyoung Seop , Kim, Yong Wook , Park, Chang Il , Rho, Hyuck Jae , Park, Jong Bum; J Korean Acad Rehabil Med 2007;31(3):351-355.

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“Mirror-writing” is the simultaneous process of reversing individual letters and composing word strings in reverse direction. It is reported that the lesions which cause “mirror-writing” are left parietal lobe, left basal ganglia, right supplementary motor area, left supplementary motor area, left cingulate gyrus, and left angular gyrus. To explain this phenomenon, several theories have been proposed such as the motor, the visual dominance, the supplementary motor area, the visio-spatial, the visual word- form, the hemisaptial factor or directional and the reflected graphemic representation hypotheses. With reviewing some of literatures, we present a case of “mirror- writing” of posterior corpus callosum lesion which is not included in the aforementioned those. (J Korean Acad Rehab Med 2007; 31: 351-355)

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A Case of Acrocallosal Syndrome with Developmental Delay: A case report.: Cho, Jin Hong , Shin, Dong Hun , Lee, Eun Shin , Yoon, Chul Ho , Shin, Hee Suk; J Korean Acad Rehabil Med 2003;27(6):997-999.

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Agenesis of the corpus callosum is a frequent anomaly that presents with a spectrum of clinical features and exhibits variable findings in neurological studies. Callosal agenesis may be an isolated anomaly or may be syndromic as part of more extensive malformations, metabolic and genetic disorders. We experienced a case of agenesis of corpus callosum with developmental delay, diagnosed to acrocallosal syndrome. Acrocallosal syndrome is an autosomal recessive condition, characterized by agenesis of the corpus callosum, pre- and postaxial polydactyly, minor craniofacial anomalies, and, in most patients, severe psychomotor retardation. We here reported a case of acrocallosal syn drome with the review of literatures. (J Korean Acad Rehab Med 2003; 27: 997-999)