The anterior and posterior commissures, centrum semiovale, and other white matter tracts such as the long association fibers and the middle cerebral peduncles may also be affected. However, the internal capsule and corona radiata as well as the shorter arcuate subgyral association fibers are typically spared. If the splenium of the corpus callosum is affected, it is more common to see the greatest degeneration in the lateral portions of the middle segment. Analyses of such cases have revealed several patterns. There can be scattered lesions or cysts at intervals from the front to the back of the callosum.
Histopathological studies reveal abundant macrophages in the lesioned areas.
Otherwise, there is little inflammatory reaction. Deep within the lesion there may be cavitation or cyst formation corresponding to complete necrosis of all neural and glial elements. There is no specific treatment. Seizures and coma are treated as described in the specific chapters in this reference. Patients who survive should receive rehabilitation and, if appropriate, alcohol and nutritional counseling.