Hemisplenial- accompanied by internal border-zone infarction: clinical relevance of the splenium of the corpus callosum as a border-zone area between anterior and posterior cerebral arteries

Infarctionof the corpus callosum(CC) is rare because it receives a rich supply of blood from the anterior and posterior circulation.1 We present a patient with severe haemodynamic insufficiency (HI) of the cerebral hemispheredue to steno-occlusive disease of the bilateral internal carotid arteries (ICA). His ipsilateral hemisplenial infarctionof the CC enlarged progressively. We discuss the clinical relevance of the spleniumof the CC as a border-zone(BZ) area between the anterior- and posterior cerebral arteries(ACA, PCA). This 63-year-old right-handed man with a medical history of hypertension and diabetes mellitus presented with dysarthria, lack of motivation and memory difficulties. MRI showed multiple acute infarctsin the internal BZ area and a single spotty infarctin the hemisplenium of the CC on the left side (figure 1A). We considered his dysarthriato be attributable to infarctionof the BZ area, but we did not know whether the infarctin the CC hemispelnium was asymptomatic or played no role in his memory disturbance. Magnetic resonance- and digital subtraction angiography(MRA, DSA) revealed occlusion of the left ICA and severe stenosis of the right cervical ICA. The capacity of the left PCA was …