• Yan Li, Zhengyang Wang, Sijia Lai, Manfei Li, Huihui Liang, Hui Qin, and Kaihua Wang.
• Guangxi International Zhuang Medicine Hospital, Nanning, China.
• Medicine (Baltimore). 2023 Aug 4; 102 (31): e34568e34568.

BackgroundReversible splenial lesion syndrome (RESLES) is a newly recognized syndrome. Its typical pathologic findings is a reversible progress correlated with transiently reduced diffusion lesion in the splenium of the corpus callosum. The common clinical symptoms include mildly altered states consciousness, delirium, and seizure.MethodsWe presented a 21-year-old patient with signs of acute ischemic stroke (AIS), including symptoms of weakness on the right upper limb and aphasia, lasting 50 minutes until he was taken to the emergency. He just had a cough 20 days ago.ResultsAn elevated level of white blood cell count, neutrophil count, monocyte count, protein of cerebrospinal fluid was found in laboratory examinations. Magnetic resonance imaging revealed distinct lesions involving white matter in the splenium of the corpus callosum and frontal-parietal cortex on both cerebral hemispheres. Digital subtraction angiography examination was also unremarkable. The patient recovered to baseline within 4 days. We treated the patient with glucocorticoid, antiviral drugs, butylphthalide, and dehydrating drugs. In addition, the follow-up brain magnetic resonance imaging scan showed reduced lesions. AIS-like symptoms did not occur during a 30-day follow-up period.ConclusionThis patient with reversible splenial lesion syndrome type II exhibited AIS-like symptoms, which was uncommon on clinical. This case extends the recognized clinical phenotypes for this disorder.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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