Mechanism of injury to the corpus callosum, with particular reference to the anatomical relationship between site of injury and adjacent brain structures.

The location of corpus callosum injury was investigated using magnetic resonance imaging in 92 patients. The anatomical relationships in the region around the corpus callosum were also evaluated to clarify involvement in the mechanism of corpus callosum injury in 20 normal volunteers. Lesions in the posterior half of the corpus callosum accounted for 80% of corpus callosum injuries. The falx was increasingly elongated toward the posterior portion of the corpus callosum and the corpus callosum was thinnest at the body-splenium junction in the normal volunteers. The mechanism of corpus callosum injury apparently involves the following factors. The posterior half of the falx is closer to the corpus callosum than the anterior half. Therefore, the anterior part of the corpus callosum easily moves with lateral movement of the cerebral hemispheres, and the strain is likely to be concentrated in the posterior half of the corpus callosum, because the falx greatly limits lateral movement of the hemisphere in the posterior region. The corpus callosum is easily distorted at the thinnest part of the body-splenium junction. Therefore, corpus callosum injury predominantly occurs in the posterior half of the corpus callosum.