Journal of Neurology Research, ISSN 1923-2845 print, 1923-2853 online, Open Access
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Case Report

Volume 16, Number 2, June 2026, pages 115-121

Transient Akinetic Mutism Following Partial Corpus Callosum Infarction After Rupture of a Distal Anterior Cerebral Artery Microaneurysm

Figures

↓  Figure 1. Head computed tomography reveals a subarachnoid hemorrhage accompanied by a localized medial hemispheric sulcal hematoma. (a) Axial image. (b) Sagittal image.
Figure 1.
↓  Figure 2. Cerebral angiography reveals a small cerebral aneurysm at the junction of the right pericallosal and the callosomarginal artery (white arrow).
Figure 2.
↓  Figure 3. Based on CTA in three directions, the aneurysm is not located at the thickest part of the hematoma but is contained within the hematoma (black circle). (a) Axial CTA image. (b) Coronal CTA image. (c) Sagittal CTA image. CTA: computed tomography angiography.
Figure 3.
↓  Figure 4. Clipping is performed. (a) The aneurysm wall was extremely thin, and the black thrombus was visible within it. (b) The aneurysm was clipped. (c) Indocyanine green angiography was performed, and the callosomarginal artery, pericallosal artery, right A2 segment, and left pericallosal artery were visualized. Black arrow: aneurysm. Black arrow head: callosomarginal artery. White arrow head: pericallosal artery.
Figure 4.
↓  Figure 5. On the day after the surgery, diffusion-weighted imaging on MRI revealed a cerebral infarction predominantly located in the corpus callosum. (a) Axial image of diffusion-weighted image. (b) Axial image of apparent diffusion coefficient map. (c) Axial image of fluid-attenuated inversion recovery.
Figure 5.
↓  Figure 6. On day 14, diffusion-weighted image and fluid-attenuated inversion recovery on MRI revealed a high intensity area in the anterior part of the corpus callosum. (a) Axial image of diffusion-weighted image. (b) Coronal image of diffusion-weighted image. (c) Sagittal image of diffusion-weighted image. (d) Axial image of fluid-attenuated inversion recovery. (e) Coronal image of fluid-attenuated inversion recovery. (f) Sagittal image of fluid-attenuated inversion recovery. MRI: magnetic resonance imaging.
Figure 6.

Table

↓  Table 1. Subarachnoid Hemorrhage Predominantly Accompanied by CC Infarction
 
CaseAge/sexLocation of aneurysmLocalized medial hemispheric sulcal hematomaTreatmentACA spasmExtent and location of CC infarctionAMOnset of AMImprovement period of AMOutcome
ACA: anterior cerebral artery; AM: akinetic mutism; CC: corpus callosum; mRS: modified Rankin Scale; P-CA: pericallosal callosomarginal artery.
Takahashi et al [6]42/FA1-A2 junction-Clip+Entire-N/AN/AModerate bilateral hemiparesis at discharge
Alnaami, et al [8]23/MP-CA junction+Coil-Body+Postoperative period3 months laterComplete recovery at 3 months
Abbuehl et al [9]50s/FA3 (branch of callosomarginal artery)+Coil+Entire+Postoperative periodSpasms persisted until day 25; AM improved after the spasms improvedPersistent disconnection syndrome with residual cognitive deficits
Our case54/FP-CA junction+Clip-Body and genu+Postoperative periodSpeech began around day 22 and gradually improvedmRS 1 (6 months)