Ischaemic stroke of the fornix and genu of the corpus callosum presenting with a Korsakoff-like syndrome

• Published in: BMJ case reports Vol. 12; no. 3; p. e228506
• Main Authors: Boardman, Jeremy, Zermansky, Adam
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01-03-2019; BMJ Publishing Group
• Subjects: Aged, 80 and over; Brain Ischemia - complications; Brain Ischemia - pathology; Case reports; Corpus Callosum - blood supply; Encephalitis; Family medical history; Fornix, Brain - blood supply; Humans; Images In; Korsakoff Syndrome - etiology; Male; Memory; Stroke; Stroke - complications; Stroke - pathology; Syndrome; memory disorders; stroke
• ISSN: 1757-790X; 1757-790X
• DOI: 10.1136/bcr-2018-228506

Cerebrospinal fluid (CSF) constituents showed a mildly raised white cell count of 9×106/L and protein 0.57 g/L. MRI scan 5 days after onset of symptoms showed a lesion in the anterior corpus callosum and bilateral columns of the fornix with high signal on diffusion-weighted imaging and low signal on the apparent diffusion coefficient (ADC) map, consistent with acute infarction (figure 1). Though previously described,2 acute amnestic syndrome due to infarction of the fornix is a rarity, most commonly reported as a complication of endovascular treatment of AcoA aneuryms.3 While this presentation may lead the clinician to consider aetiologies such as thiamine deficiency, Marchiafava-Bignami disease and even HSV encephalitis, the tempo of onset, in this case, was more suggestive of a vascular cause.