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Extensive traumatic axonal injury of brain due to violence: A case report

RATIONALE: Many studies using diffusion tensor imaging (DTI) have demonstrated traumatic axonal injury (TAI) in patients whose conventional brain magnetic resonance imaging (MRI) results are negative following head trauma. Injury mechanism for TAI in these patients has been mainly associated with mo...

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Autores principales: Jang, Sung Ho, Kim, Seong Ho, Kwon, Young Hyeon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6283135/
https://www.ncbi.nlm.nih.gov/pubmed/30508923
http://dx.doi.org/10.1097/MD.0000000000013315
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author Jang, Sung Ho
Kim, Seong Ho
Kwon, Young Hyeon
author_facet Jang, Sung Ho
Kim, Seong Ho
Kwon, Young Hyeon
author_sort Jang, Sung Ho
collection PubMed
description RATIONALE: Many studies using diffusion tensor imaging (DTI) have demonstrated traumatic axonal injury (TAI) in patients whose conventional brain magnetic resonance imaging (MRI) results are negative following head trauma. Injury mechanism for TAI in these patients has been mainly associated with motor vehicle accident, whereas very little is known about TAI by violence. PATIENT CONCERNS: A 42-year-old male patient presented after experiencing head trauma due to violence. His face was hit several times by 2 men, and 1 of the men kicked the right side of the patient's head, after which the patient's left parietal area hit the ground while falling. After the head trauma, he felt mild motor weakness of the left upper and lower extremities and had mild articulation difficulty, cognitive dysfunction including memory impairment, and excessive daytime sleepiness. DIAGNOSES: The patient was diagnosed as TAI. INTERVENTIONS: Clinical assessments and DTI were performed at 10 days after the head trauma. OUTCOMES: He showed mild left hemiparesis (5/4), mild dysarthria, mild cognitive abnormality (Clinical Dementia Rating: 0.5) and mild abnormality on the Epworth Sleepiness Scale (score: 12; cut-off score: 10, maximum score: 24). DTI showed the following configurational abnormalities: right corticospinal tract narrowing, left corticobulbar tract narrowing, discontinuations in the anterior portion of both cingula, discontinuation of the left fornical crus, non-reconstruction of the right dorsolateral prefronto-thalamic tract, and narrowing in both lower ventral ascending reticular activating systems. LESSONS: Extensive TAI of various neural tracts was demonstrated by performing DTI of a patient with head trauma due to violence. Analysis of the neural tracts via DTI can be useful in detection of TAI in patients who show various neurological features following head trauma due to violence.
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spelling pubmed-62831352018-12-26 Extensive traumatic axonal injury of brain due to violence: A case report Jang, Sung Ho Kim, Seong Ho Kwon, Young Hyeon Medicine (Baltimore) Research Article RATIONALE: Many studies using diffusion tensor imaging (DTI) have demonstrated traumatic axonal injury (TAI) in patients whose conventional brain magnetic resonance imaging (MRI) results are negative following head trauma. Injury mechanism for TAI in these patients has been mainly associated with motor vehicle accident, whereas very little is known about TAI by violence. PATIENT CONCERNS: A 42-year-old male patient presented after experiencing head trauma due to violence. His face was hit several times by 2 men, and 1 of the men kicked the right side of the patient's head, after which the patient's left parietal area hit the ground while falling. After the head trauma, he felt mild motor weakness of the left upper and lower extremities and had mild articulation difficulty, cognitive dysfunction including memory impairment, and excessive daytime sleepiness. DIAGNOSES: The patient was diagnosed as TAI. INTERVENTIONS: Clinical assessments and DTI were performed at 10 days after the head trauma. OUTCOMES: He showed mild left hemiparesis (5/4), mild dysarthria, mild cognitive abnormality (Clinical Dementia Rating: 0.5) and mild abnormality on the Epworth Sleepiness Scale (score: 12; cut-off score: 10, maximum score: 24). DTI showed the following configurational abnormalities: right corticospinal tract narrowing, left corticobulbar tract narrowing, discontinuations in the anterior portion of both cingula, discontinuation of the left fornical crus, non-reconstruction of the right dorsolateral prefronto-thalamic tract, and narrowing in both lower ventral ascending reticular activating systems. LESSONS: Extensive TAI of various neural tracts was demonstrated by performing DTI of a patient with head trauma due to violence. Analysis of the neural tracts via DTI can be useful in detection of TAI in patients who show various neurological features following head trauma due to violence. Wolters Kluwer Health 2018-11-30 /pmc/articles/PMC6283135/ /pubmed/30508923 http://dx.doi.org/10.1097/MD.0000000000013315 Text en Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0
spellingShingle Research Article
Jang, Sung Ho
Kim, Seong Ho
Kwon, Young Hyeon
Extensive traumatic axonal injury of brain due to violence: A case report
title Extensive traumatic axonal injury of brain due to violence: A case report
title_full Extensive traumatic axonal injury of brain due to violence: A case report
title_fullStr Extensive traumatic axonal injury of brain due to violence: A case report
title_full_unstemmed Extensive traumatic axonal injury of brain due to violence: A case report
title_short Extensive traumatic axonal injury of brain due to violence: A case report
title_sort extensive traumatic axonal injury of brain due to violence: a case report
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6283135/
https://www.ncbi.nlm.nih.gov/pubmed/30508923
http://dx.doi.org/10.1097/MD.0000000000013315
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