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Hemisplenial- accompanied by internal border-zone infarction: clinical relevance of the splenium of the corpus callosum as a border-zone area between anterior and posterior cerebral arteries
  1. Akihito Hashiguchi1,
  2. Shigetoshi Yano2,
  3. Kazumi Nitta1,
  4. Wataru Ide1,
  5. Ikuo Hashimoto1,
  6. Hajime Kamada1,
  7. Jun-ichi Kuratsu2
  1. 1Department of Neurosurgery, Hokuto Hospital, Obihiro, Hokkaido, Japan
  2. 2Department of Neurosurgery, Graduate School of Medical and Pharmaceutical Sciences, Kumamoto University, Honjo, Kumamoto, Japan
  1. Correspondence to Dr Akihito Hashiguchi, Department of Neurosurgery, Hokuto Hospital, 7-5 Inada, Obihiro, Hokkaido 080-0039, Japan; hashiguchi{at}hokuto7.or.jp

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Infarction of the corpus callosum (CC) is rare because it receives a rich supply of blood from the anterior and posterior circulation.1 We present a patient with severe haemodynamic insufficiency (HI) of the cerebral hemisphere due to steno-occlusive disease of the bilateral internal carotid arteries (ICA). His ipsilateral hemisplenial infarction of the CC enlarged progressively. We discuss the clinical relevance of the splenium of the CC as a border-zone (BZ) area between the anterior- and posterior cerebral arteries (ACA, PCA).

Case report

This 63-year-old right-handed man with a medical history of hypertension and diabetes mellitus presented with dysarthria, lack of motivation and memory difficulties. MRI showed multiple acute infarcts in the internal BZ area and a single spotty infarct in the hemisplenium of the CC on the left side (figure 1A). We considered his dysarthria to be attributable to infarction of the BZ area, but we did not know whether the infarct in the CC hemispelnium was asymptomatic or played no role in his memory disturbance. Magnetic resonance- and digital subtraction angiography (MRA, DSA) revealed occlusion of the left ICA and severe stenosis of the right cervical ICA. The capacity of the left PCA was …

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