Reversible splenial lesion syndrome type Ⅱ with stroke⁃like onset: two cases report

Objective To report 2 cases of reversible splenial lesion syndrome (RESLES) typeⅡpresented with stroke⁃like attacks, and summarize the pathogenesis and imaging findings based on the literature to improve clinicians' understanding of RESLES, especially typeⅡ. Methods and Results The 2 young male patients were both RESLES typeⅡcases admitted to the People's Hospital of Guangxi Zhuang Autonomous Region from July 2018 to June 2021, presented with stroke⁃like attacks such as slurred speech and limb weakness, and developed symptoms of acute intracranial hypertension such as dizziness, nausea, and so on. During the course of the disease, both of them had a history of alcohol consumption and smoking or metabolic disorders, physical examination and laboratory indicators were unremarkable, and head MRI examination showed symmetrical and reversible long T1, long T2 and DWI hyperintensity lesions in the splenium of corpus callosum and surrounding white matter. After symptomatic treatment such as anti⁃inflammatory, improving blood circulation, and nourishing nerves, imaging findings showed the lesions subsided, and the symptoms and signs were completely relieved. There was no recurrence of the disease during the follow⁃up period, the patients have returned to their daily life and work, and the diagnosis of RESLES typeⅡwas clear. Conclusions For young patients with stroke⁃like attacks and no risk factors for atherosclerosis, the possibility of RESLES should be considered, and MRI especially DWI can quickly confirm the diagnosis.