Corpus callosum infarcts may present acutely or with slowly evolving and non-localizing neurologic signs and symptoms that suggest the diagnosis of tumor rather than infarct. 2 Isolated infarcts of the anterior and posterior cerebral arteries are uncommon and usually occur in patients with generalized atherosclerosis associated with long-standing hypertension and diabetes mellitus. The pericallosal branch of the anterior cerebral artery is typically the main vascular supply to the body. Moreover, the penetrating arteries of corpus callosum run perpendicular to the parent artery, thus protecting it from emboli. 1 Also, the corpus callosum is a dense white matter tract, which makes it less sensitive to ischemic injury than gray matter. Discussion Bilateral strokes of the corpus callosum are uncommon because of the rich blood supply of this structure from 3 main arterial systems: namely, the anterior communicating, anterior cerebral, and posterior cerebral arteries. He recovered within several months with only minor residual motor weakness. The patient underwent subacute rehabilitation aspirin, clopidogrel, and simvastatin were prescribed. The results of diffusion-weighted MRI of the brain were consistent with corpus callosum ischemic stroke crossing the midline. Initial differential diagnoses of glioblastoma multiforme, lymphoma, and multiple sclerosis were entertained on the basis of the CT findings. Administration of tPA was deferred because of the recent stroke. A second CT brain scan showed a bilateral corpus callosum lesion ( Figure). On the second day of rehabilitation, the patient became aphasic and lethargic he was also found to have abulia (loss or deficiency of willful initiative or drive) and left-sided apraxia (loss of the ability to carry out learned purposeful movements). The patient was admitted for observation and later transferred for inpatient rehabilitation. Initial laboratory results were unremarkable. Physical examination revealed right facial weakness motor strength was 4/5 in the right upper extremity and 3/5 in the right lower extremity. Tissue plasminogen activator (tPA) was not given because the event was of 3 days’ duration. A CT scan of the brain showed a left anterior cerebral artery ischemic stroke. A 47-year-old man with hypertension, hyperlipidemia, and chronic cocaine and alcohol abuse presented with a 3-day history of right-sided weakness and numbness.
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