Journal of Neuroradiology (2010) 37, 243—246 CASE REPORT Reversible splenial lesion syndrome in cerebral malaria Neuropaludisme et lésion réversible du corps calleux P. Hantson a,* , D. Hernalsteen b , G. Cosnard b a Department of Intensive Care, cliniques universitaires Saint-Luc, université catholique de Louvain, 10, avenue Hippocrate, 1200 Brussels, Belgium b Department of Radiology, cliniques universitaires Saint-Luc, université catholique de Louvain, Brussels, Belgium Available online 8 April 2010 KEYWORDS Plasmodium falciparum; Cerebral malaria; Magnetic resonance imaging; Reversible splenial encephalopathy; Corpus callosum Summary A 71-year-old Caucasian man living in Congo was investigated by serial magnetic res- onance imaging (MRI) after having presented cerebral malaria due to Plasmodium falciparum. The clinical picture was characterized initially by coma and seizures. The patient developed multiple organ failure. There was, at 4 months follow-up only, a minimal neurological improve- ment consistent with minimally conscious state. The first cerebral MRI on day 17 showed a lesion of the splenium of corpus callosum with high signal intensity on DWI and FLAIR sequence and reduced ADC, and small cortical infarcts in the internal occipital regions. Follow-up MRI obtained 36 days later showed a complete resolution of splenial lesion, though without clini- cal improvement. Cerebral malaria should be added to the list of possible causes of reversible lesion of the splenium of corpus callosum. © 2010 Elsevier Masson SAS. All rights reserved. Introduction Cerebral malaria is one of the most serious complications in Plasmodium falciparum infection. The clinical picture is usually characterized by encephalopathy with seizures and loss of consciousness. The final prognosis of the comatose forms is usually poor. The pathogenesis of cerebral malaria is still unclear. It seems that the cerebral complications may result from concomitant microvessel obstruction and inflam- mation [1,2]. * Corresponding author. E-mail address: philippe.hantson@uclouvain.be (P. Hantson). There are in the literature relatively few data regarding the in vivo imaging studies of cerebral malaria and only one case with splenial lesion [3]. Case report A 71-year-old Caucasian man with a previous medical his- tory of arterial hypertension, coronary disease, diabetes, hypercholesterolemia, and nephrolithiasis was diagnosed Plasmodium falciparum cerebral malaria. He had been living in the Democratic Republic of Congo for 35 years and did not take any prophylaxis. When visiting his daughter in Canada, he developed fever, confusion, and general weakness. Plas- modium falciparum was seen on the blood smear and the parasitemia was estimated at 5%. The patient became 0150-9861/$ – see front matter © 2010 Elsevier Masson SAS. All rights reserved. doi:10.1016/j.neurad.2009.12.005 © 2021 Elsevier Masson SAS. Tous droits réservés. - Document téléchargé le 13/12/2021 Il est interdit et illégal de diffuser ce document.