Cytotoxic Lesions of the Corpus Callosum (CLOCC): Four Case Reports

The corpus callosum serves as the primary commissural region of the brain, comprising white matter tracts that facilitate interhemispheric communication between the left and right cerebral hemispheres.It consists of approximately 200 million heavily myelinated axons, which form homotopic or heterotopic projections to contralateral neurons within the same anatomical layer.The corpus callosum is conventionally divided into four distinct parts: the rostrum, genu, body, and splenium.These components connect corresponding centers in the right and left cerebral hemispheres, thereby enabling comprehensive neural coordination.Cytotoxic lesions of the corpus callosum (CLOCC) represent unusual clinical conditions characterized by diverse presentations.This study presents four cases of CLOCC.The first case involved a 41-year-old male patient who presented with symptoms of fever, blurred vision, and fatigue.The second case concerned a 21-year-old female patient who presented with headache, fever, tinnitus, and sore throat.The third case involved a 65-year-old female patient who presented with headache, focal seizures with impaired awareness, and confusion.The fourth case involved a 64-year-old female who presented with global aphasia and right hemiparesis; she developed a fever during clinical follow-up.Upon evaluating the etiology of CLOCC, an undetermined infection following a dental procedure was identified in the first case, lobar pneumonia in the second case, and sinus venous thrombosis in the third case.Additionally, the third case developed epileptic seizures during follow-up.In the fourth case, a bacterial infection of undetermined origin that resolved with empirical antibiotic therapy was considered the etiology.Diagnosis involves identifying acute diffusion restriction in the corpus callosum using diffusion MRI.CLOCC should be considered in the differential diagnosis of patients presenting with undiagnosed neurological findings.These lesions are often reversible and have a favorable prognosis, depending on the underlying cause.Radiological identification is crucial for selecting appropriate treatment options.