scholarly journals Diffusion-Tensor-Tractography-Based Diagnosis for Injury of Corticospinal Tract in a Patient with Hemiplegia Following Traumatic Brain Injury

Diagnostics ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. 156 ◽  
Author(s):  
Chan-Hyuk Park ◽  
Su-Hong Kim ◽  
Han-Young Jung
Keyword(s):  
Traumatic Brain Injury ◽  
Cerebral Cortex ◽  
Brain Injury ◽  
Corticospinal Tract ◽  
Diffusion Tensor ◽  
The Body ◽  
Diffusion Tensor Tractography ◽  
Motor Weakness ◽  
Level Of Consciousness ◽  
The Right

This paper reports a mechanism for corticospinal tract injury in a patient with hemiplegia following traumatic brain injury (TBI) based on diffusion tensor tractography (DTT) finding. A 73-year-old male with TBI resulting from a fall, without medical history, was diagnosed as having left convexity epidural hematoma (EDH). He underwent craniotomy and suffered motor weakness on the right side of the body. Two weeks after onset, he was transferred to a rehabilitation department with an alerted level of consciousness. Four weeks after onset, his motor functions were grade 1 by the Medical Research Council’s (MRC) standards in the right-side limbs and grade 4 in the left-side limbs. The result of DTT using the different regions of interest (ROIs) showed that most of the right corticospinal tract (CST) did not reach the cerebral cortex around where the EDH was located, and when the ROI was placed on upper pons, a disconnection of the CST was shown and a connection of the CST in ROI with the middle pons appeared. However, the right CST was connected to the cerebral cortex below the pons regardless of ROI. This study is the first report to use DTT to detect that the discontinuation of the left CST in the cerebral cortex and injury lesions below the lower pons and between the upper and lower pons are responsible for motor weakness in a patient.

scholarly journals Injury of Corticospinal Tract in a Patient with Subarachnoid Hemorrhage as Determined by Diffusion Tensor Tractography: A Case Report

2020 ◽  
Vol 10 (3) ◽  
pp. 177 ◽  
Author(s):  
Chan-Hyuk Park ◽  
Hyeong Ryu ◽  
Chang-Hwan Kim ◽  
Kyung-Lim Joa ◽  
Myeong-Ok Kim ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Corticospinal Tract ◽  
Diffusion Tensor ◽  
Mean Diffusivity ◽  
Diffusion Tensor Tractography ◽  
Lower Limbs ◽  
Anterior Communicating Artery ◽  
Motor Weakness ◽  
Corona Radiata ◽  
The Right

We report diffusion tensor tractography (DTT) of the corticospinal tract (CST) in a patient with paresis of all four limbs following subarachnoid hemorrhage (SAH) with intraventricular hemorrhage (IVH) after the rupture of an anterior communicating artery (ACoA) aneurysm rupture. The 73-year-old female was admitted to our emergency room in a semi-comatose mental state. After coil embolization—an acute SAH treatment—she was transferred to our rehabilitation department with motor weakness development, two weeks after SAH. Upon admission, she was alert but she complained of motor weakness (upper limbs: MRC 3/5, and lower limbs: MRC 1/5). Four weeks after onset, DTT showed that the bilateral CSTs failed to reach the cerebral cortex. The left CST demonstrated a wide spread of fibers within the corona radiata as well as significantly lower tract volume (TV) and higher fractional anisotropy (FA) as well as mean diffusivity (MD) compared to the controls. On the other hand, the right CST shifted to the posterior region at the corona radiata, and MD values of the right CST were significantly higher when compared to the controls. Changes in both CSTs were attributed to vasogenic edema and compression caused by untreated hydrocephalus. We demonstrate in this case, two different pathophysiological entitles, contributing to this patient’s motor weakness after SAH.

scholarly journals Diagnosis of Complex Regional Pain Syndrome I Following Traumatic Axonal Injury of the Corticospinal Tract in a Patient with Mild Traumatic Brain Injury

Diagnostics ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. 95 ◽  
Author(s):  
Sung Ho Jang ◽  
You Sung Seo
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Complex Regional Pain Syndrome ◽  
Mild Traumatic Brain Injury ◽  
Corticospinal Tract ◽  
Axonal Injury ◽  
Pain Syndrome ◽  
Traumatic Axonal Injury ◽  
Right Hand ◽  
The Right

A 54-year-old male suffered from direct head trauma resulting from a fall while working. At approximately two months after the accident, he began to feel pain (burning sensation) and swelling of the dorsum of the right hand and wrist. He showed the following clinical features among the clinical signs and symptoms of revised diagnostic criteria for complex regional pain syndrome (CRPS): spontaneous pain, mechanical hyperalgesia, vasodilation, skin temperature asymmetries, skin color changes, swelling, motor weakness. No specific lesion was observed on brain MRI taken at ten weeks after onset. Plain X-ray, electromyography, and nerve conduction studies for the right upper extremity detected no abnormality. A three-phase bone scan showed hot uptake in the right wrist in the delayed image. On two-month diffusion tensor tractography, partial tearing of the corticospinal tract (CST) was observed at the subcortical white matter in both hemispheres (much more severe in the left CST). In addition, the fiber number of the right CST was significantly decreased than that of seven normal control subjects. CRPS I of the right hand in this patient appeared to be related to traumatic axonal injury of the left CST following mild traumatic brain injury.

Relation between cingulum injury and cognition in chronic patients with traumatic brain injury; diffusion tensor tractography study

2013 ◽  
Vol 33 (3) ◽  
pp. 465-471 ◽  
Author(s):  
Seung Ok Baek ◽  
Oh Lyong Kim ◽  
Seong Ho Kim ◽  
Min Soo Kim ◽  
Su Min Son ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Diffusion Tensor ◽  
Diffusion Tensor Tractography ◽  
Chronic Patients
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