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

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 e...

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Autores principales: Park, Chan-Hyuk, Kim, Su-Hong, Jung, Han-Young
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7151234/
https://www.ncbi.nlm.nih.gov/pubmed/32183086
http://dx.doi.org/10.3390/diagnostics10030156
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author Park, Chan-Hyuk
Kim, Su-Hong
Jung, Han-Young
author_facet Park, Chan-Hyuk
Kim, Su-Hong
Jung, Han-Young
author_sort Park, Chan-Hyuk
collection PubMed
description 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.
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spelling pubmed-71512342020-04-20 Diffusion-Tensor-Tractography-Based Diagnosis for Injury of Corticospinal Tract in a Patient with Hemiplegia Following Traumatic Brain Injury Park, Chan-Hyuk Kim, Su-Hong Jung, Han-Young Diagnostics (Basel) Case Report 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. MDPI 2020-03-13 /pmc/articles/PMC7151234/ /pubmed/32183086 http://dx.doi.org/10.3390/diagnostics10030156 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Park, Chan-Hyuk
Kim, Su-Hong
Jung, Han-Young
Diffusion-Tensor-Tractography-Based Diagnosis for Injury of Corticospinal Tract in a Patient with Hemiplegia Following Traumatic Brain Injury
title Diffusion-Tensor-Tractography-Based Diagnosis for Injury of Corticospinal Tract in a Patient with Hemiplegia Following Traumatic Brain Injury
title_full Diffusion-Tensor-Tractography-Based Diagnosis for Injury of Corticospinal Tract in a Patient with Hemiplegia Following Traumatic Brain Injury
title_fullStr Diffusion-Tensor-Tractography-Based Diagnosis for Injury of Corticospinal Tract in a Patient with Hemiplegia Following Traumatic Brain Injury
title_full_unstemmed Diffusion-Tensor-Tractography-Based Diagnosis for Injury of Corticospinal Tract in a Patient with Hemiplegia Following Traumatic Brain Injury
title_short Diffusion-Tensor-Tractography-Based Diagnosis for Injury of Corticospinal Tract in a Patient with Hemiplegia Following Traumatic Brain Injury
title_sort diffusion-tensor-tractography-based diagnosis for injury of corticospinal tract in a patient with hemiplegia following traumatic brain injury
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7151234/
https://www.ncbi.nlm.nih.gov/pubmed/32183086
http://dx.doi.org/10.3390/diagnostics10030156
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