Extensive corpus callosum infarction: an unusual presentation with unexpected neuroimaging

Abstract Background Corpus callosum infarctions are rare due to the region’s dual vascular supply and often present with nonspecific or atypical symptoms. The resulting diagnostic delay may impact management and outcomes. Case presentation We report a case of a female patient in her early sixties with a background of hypertension, diabetes mellitus, and stage IV chronic kidney disease. She presented with acute coronary syndrome and pulmonary edema. During hospitalization, she developed a new-onset cognitive decline, with a Mini-Mental State Examination (MMSE) score of 16/30. Neurological examination revealed no focal deficits but marked cognitive slowing. MRI of the brain showed acute infarction involving the entire corpus callosum. Workup for embolic sources and alternative diagnoses was unremarkable. The patient was managed conservatively due to comorbidities and gradually improved. Her MMSE improved to 24/30 at 1-week follow-up. Conclusion This case highlights the importance of considering corpus callosum infarction in patients presenting with unexplained cognitive changes, especially in the presence of vascular risk factors. Neuroimaging, particularly MRI, plays a pivotal role in diagnosis. Early identification and neurorehabilitation may improve cognitive outcomes.