Reversible Transient Lesion of the Corpus Callosum Secondary to Meningoencephalitis

Aidan (Jia Sheng) Yu, Shelly (Chia Yuan) Lee

Abstract

A 40-year-old male, presented with right-sided weakness, ataxia, expressive dysphasia and was treated for cerebrovascular accident (CVA). However, he became increasingly confused, disorientated and reported worsening headache along with fevers, photophobia and neck stiffness. On further history, the patient’s family reported the patient as being more confused and incoherent rather than having true ataxia and expressive dysphasia. CSF results were consistent with viral meningoencephalitis and MRI revealed a crescent shaped splenial lesion. He was treated empirically with ceftriaxone and acyclovir. On follow up, he remained symptom free and MRI showed regression of the splenial lesion. Reversible transient splenial lesions of the corpus callosum secondary to viral meningoencephalitis are rarely encountered. This case highlights the importance of exploring different aetiologies of splenial lesions to avoid misdiagnoses with more commonly seen conditions such as CVA.
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