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Is it coincidental or correlative between reversible splenial lesion syndrome and atrial septal defect?: A case report

RATIONALE: Reversible splenial lesion syndrome (RESLES) is a recently identified clinico-radiological syndrome, the etiology is miscellaneous. Atrial septal defect (ASD) as an underlying etiology for RESLES has not been reported. We first report a rare case of RESLES associated with ASD. The clinica...

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Autores principales: Li, Jiangang, Chen, Yingcong, Liu, Jianxue, Mai, Xingsheng, Jing, Shaohua
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7581157/
https://www.ncbi.nlm.nih.gov/pubmed/33120844
http://dx.doi.org/10.1097/MD.0000000000022920
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author Li, Jiangang
Chen, Yingcong
Liu, Jianxue
Mai, Xingsheng
Jing, Shaohua
author_facet Li, Jiangang
Chen, Yingcong
Liu, Jianxue
Mai, Xingsheng
Jing, Shaohua
author_sort Li, Jiangang
collection PubMed
description RATIONALE: Reversible splenial lesion syndrome (RESLES) is a recently identified clinico-radiological syndrome, the etiology is miscellaneous. Atrial septal defect (ASD) as an underlying etiology for RESLES has not been reported. We first report a rare case of RESLES associated with ASD. The clinical, radiological, and ultrasonic profiles were presented and the pathophysiological mechanism was analyzed. PATIENT CONCERNS: A 23-year-old man presented with headache, drowsiness, occasional paraphasia, and paroxysmal dry cough. Brain magnetic resonance imaging (MRI) on admission showed an ovoid isolated lesion in the splenium of corpus callosum, which exhibited hyperintensity on diffusion-weighted imaging and hypointensity on apparent diffusion coefficient, and completely disappeared on the follow-up MRI 14 days later. ASD was found by transthoracic echocardiography, Right-to-left shunts were detected on color Doppler of transesophageal echocardiography, and microemboli were captured by transcranial Doppler ultrasound. DIAGNOSES: According to his clinical history and imaging results, we confirmed the diagnosis of RESLES associated with ASD. INTERVENTIONS: The patient was treated by oral aspirin and lopidogrel sulfate to inhibit platelet aggregation. In addition, oral nimodipine to suppress vasoconstriction. OUTCOMES: After 14 days treatment, all the symptoms presenting on admission resolved completely. Subsequently, a repair surgery of ASD under thoracoscopy was successfully performed. LESSONS: To our knowledge, this is the first reported case of ASD may be an underlying etiology for RESLES and need require an etiotropic treatment.
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spelling pubmed-75811572020-10-30 Is it coincidental or correlative between reversible splenial lesion syndrome and atrial septal defect?: A case report Li, Jiangang Chen, Yingcong Liu, Jianxue Mai, Xingsheng Jing, Shaohua Medicine (Baltimore) 5300 RATIONALE: Reversible splenial lesion syndrome (RESLES) is a recently identified clinico-radiological syndrome, the etiology is miscellaneous. Atrial septal defect (ASD) as an underlying etiology for RESLES has not been reported. We first report a rare case of RESLES associated with ASD. The clinical, radiological, and ultrasonic profiles were presented and the pathophysiological mechanism was analyzed. PATIENT CONCERNS: A 23-year-old man presented with headache, drowsiness, occasional paraphasia, and paroxysmal dry cough. Brain magnetic resonance imaging (MRI) on admission showed an ovoid isolated lesion in the splenium of corpus callosum, which exhibited hyperintensity on diffusion-weighted imaging and hypointensity on apparent diffusion coefficient, and completely disappeared on the follow-up MRI 14 days later. ASD was found by transthoracic echocardiography, Right-to-left shunts were detected on color Doppler of transesophageal echocardiography, and microemboli were captured by transcranial Doppler ultrasound. DIAGNOSES: According to his clinical history and imaging results, we confirmed the diagnosis of RESLES associated with ASD. INTERVENTIONS: The patient was treated by oral aspirin and lopidogrel sulfate to inhibit platelet aggregation. In addition, oral nimodipine to suppress vasoconstriction. OUTCOMES: After 14 days treatment, all the symptoms presenting on admission resolved completely. Subsequently, a repair surgery of ASD under thoracoscopy was successfully performed. LESSONS: To our knowledge, this is the first reported case of ASD may be an underlying etiology for RESLES and need require an etiotropic treatment. Lippincott Williams & Wilkins 2020-10-23 /pmc/articles/PMC7581157/ /pubmed/33120844 http://dx.doi.org/10.1097/MD.0000000000022920 Text en Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0
spellingShingle 5300
Li, Jiangang
Chen, Yingcong
Liu, Jianxue
Mai, Xingsheng
Jing, Shaohua
Is it coincidental or correlative between reversible splenial lesion syndrome and atrial septal defect?: A case report
title Is it coincidental or correlative between reversible splenial lesion syndrome and atrial septal defect?: A case report
title_full Is it coincidental or correlative between reversible splenial lesion syndrome and atrial septal defect?: A case report
title_fullStr Is it coincidental or correlative between reversible splenial lesion syndrome and atrial septal defect?: A case report
title_full_unstemmed Is it coincidental or correlative between reversible splenial lesion syndrome and atrial septal defect?: A case report
title_short Is it coincidental or correlative between reversible splenial lesion syndrome and atrial septal defect?: A case report
title_sort is it coincidental or correlative between reversible splenial lesion syndrome and atrial septal defect?: a case report
topic 5300
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7581157/
https://www.ncbi.nlm.nih.gov/pubmed/33120844
http://dx.doi.org/10.1097/MD.0000000000022920
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