From the Research
The management of a splenium of corpus callosum infarct should focus on treating the underlying cause, preventing further strokes, and addressing any resulting symptoms, with an emphasis on antiplatelet therapy, high-intensity statin therapy, and blood pressure control, as supported by the most recent study 1. The initial treatment includes antiplatelet therapy with aspirin 81-325 mg daily or clopidogrel 75 mg daily, along with high-intensity statin therapy such as atorvastatin 40-80 mg or rosuvastatin 20-40 mg daily.
- Blood pressure should be controlled to <140/90 mmHg using appropriate antihypertensives.
- For patients with atrial fibrillation or other cardioembolic sources, anticoagulation with direct oral anticoagulants (DOACs) like apixaban 5 mg twice daily or warfarin (target INR 2-3) is recommended. A comprehensive stroke workup including brain imaging (MRI with diffusion-weighted imaging), vascular studies (carotid ultrasound, CT angiography), cardiac evaluation (echocardiogram, prolonged cardiac monitoring), and laboratory tests to identify risk factors should be performed, as suggested by 2. Rehabilitation may be necessary depending on specific deficits, which can include visual field defects, memory problems, or disconnection syndromes.
- The splenium connects the occipital and temporal lobes, so infarcts in this region can disrupt interhemispheric transfer of visual and language information, potentially causing alexia without agraphia or other unique neurological presentations that require targeted rehabilitation approaches, as noted in 3. It is essential to consider the potential for transient lesions in the splenium of the corpus callosum after acute ischemic stroke, as reported in 4, and to avoid misdiagnosing them and performing unnecessary examinations or treatment. The most recent study 1 highlights the importance of considering COVID-19 as a potential inciting agent for splenium of corpus callosum infarct, particularly in patients with encephalopathy and coagulopathy.