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American Journal of Roentgenology, Vol 101, 130-140, Copyright © 1967 by American Roentgen Ray Society

THE DIAGNOSIS OF TUMORS OF THE SPLENIUM OF THE CORPUS CALLOSUM

L. M. ZATZ M.D.1, J. W. HANBERY M.D.2, D. GIFFORD M.D.2, and J. BELZA M.D2

1 From the Diagnostic Division, Department of Radiology, Stanford University School of Medicine, Palo Alto, California
2 From the Neurosurgery Division, Department of Surgery, Stanford University School of Medicine, Palo Alto, California

1. Primary neoplasms of the posterior corpus callosum are usually malignant gliomas which typically show extensive invasion anteriorly into the corpus callosum, fomnix, and septum pellucidum and laterally into the centrum semiovale and mesial parietal cortex of each cerebral hemisphere.

2. An accurate diagnosis of such tumors cannot be made on clinical grounds alone.

3. On carotid arteriography the appearance in the lateral projection of the typical ballooning or cradle deformity of the deep veins of the brain in the absence of any significant degree of midline shift of the arteries on deep veins is diagnostic of a mass lesion involving the splenium of the corpus callosum. When this characteristic deformity is not seen, visualization of the posterior callosal vein on of the posterior pericallosal artery may define an enlarged splenium. The presence of a tumor stain located in the appropriate region is diagnostic but is not a constant finding. Vertebral arteriography may be useful to supplement carotid arteriography. In some cases differentiation from marked hydrocephalus may require an air study.

4. Air studies may reveal increased separation of the atria of the lateral ventricles, focal deformation of the medial aspect or roof of one or both ventricles, downward displacement of the posterior third ventricle, encroachment into the cistern of the quadrigeminal plate, and a most important differential point, thickening of the septum pellucidum.

5. Gammaencephalograms were positive in 3 out of 4 cases. They are a valuable diagnostic aid but must be supplemented by other procedures to provide accurate anatomic localization.


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Copyright © 1967 by the American Roentgen Ray Society.