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Case Reports
. 2022 Oct;64(10):2085-2089.
doi: 10.1007/s00234-022-03010-y. Epub 2022 Jul 9.

Cytotoxic lesions of the corpus callosum after COVID-19 vaccination

Hiroya Ohara  1   2 , Hironori Shimizu  1   2 , Takehito Kasamatsu  3 , Akihiro Kajita  3 , Kenji Uno  3 , Khin Wee Lai  4 , Balachandar Vellingiri  5 , Kazuma Sugie  2 , Masako Kinoshita  6   7
Affiliations
Case Reports

Cytotoxic lesions of the corpus callosum after COVID-19 vaccination

Hiroya Ohara et al. Neuroradiology. 2022 Oct.

Abstract

A 23-year-old previously healthy man (Patient 1) and a 33-year-old woman with a past history of depression (Patient 2) developed neurological symptoms approximately 1 week after receipt of the first COVID-19 mRNA vaccination and deteriorated over the next week. Patient 1 reported nausea, headache, a high fever, and retrograde amnesia. Patient 2 reported visual disturbance, headache, dysarthria, a left forearm tremor, dysesthesia of the mouth and distal limbs, and visual agnosia. PCR test results for SARS-CoV-2 were negative. Complete blood cell count, biochemistry, and antibody test and cerebrospinal fluid test findings were unremarkable. Diffusion-weighted and fluid-attenuated inversion recovery MRI of the brain showed a high signal intensity lesion at the midline of the splenium of the corpus callosum compatible with cytotoxic lesions of the corpus callosum (CLOCCs). High-dose intravenous methylprednisolone improved their symptoms and imaging findings. CLOCCs should be considered in patients with neurological manifestation after COVID-19 vaccination.

Keywords: COVID-19; COVID-19 mRNA vaccine; Coronavirus disease 2019; Cytotoxic lesions of the corpus callosum; Mild encephalitis/encephalopathy with reversible splenial lesion.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Magnetic resonance images of the brain of Patient 1 on Day 18 (A) and on Day 25 (B) after COVID-19 vaccination. A Diffusion-weighted image (DWI) (left) shows restricted diffusion in the splenium with low apparent diffusion coefficient (ADC) values (middle), and fluid-attenuated inversion recovery image (FLAIR) (right) shows a high signal intensity lesion at the midline of the splenium of the corpus callosum (arrows). B The lesion disappeared after intravenous high-dose methylprednisolone therapy
Fig. 2
Fig. 2
Magnetic resonance images of the brain of Patient 2 on Day 17 (A) and on Day 29 (B) after COVID-19 vaccination. A Diffusion-weighted image (DWI) (left) shows restricted diffusion in the splenium with low apparent diffusion coefficient (ADC) values (middle), and fluid-attenuated inversion recovery image (FLAIR) (right) shows a high signal intensity lesion at the midline of the splenium of the corpus callosum (arrows). B The lesion disappeared after intravenous high-dose methylprednisolone therapy
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