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Clinical utility of diffusion tensor imaging and fibre tractography for evaluating diffuse axonal injury with hemiparesis.

Sugiyama K, Kondo T, Suzukamo Y, Oouchida Y, Sato M, Watanabe H, Izumi S - Case Rep Med (2013)

Bottom Line: DTI fractional anisotropy revealed changes in the right cerebral peduncle, the right posterior limb of the internal capsule, and the right corona radiata when compared with the corresponding structures observed on the patient's left side and in healthy controls.On FT evaluation, the right corticospinal tract (CST) was poorly visualised as compared with the left CST as well as the CST in healthy controls.Thus, DTI and FT represent useful techniques for the evaluation of patients with DAI and motor disorders.

View Article: PubMed Central - PubMed

Affiliation: Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, 2-1 Seiryo-cho, Aoba-ku, Sendai 980-8575, Japan.

ABSTRACT
Although diffuse axonal injury (DAI) frequently manifests as cognitive and/or motor disorders, abnormal brain findings are generally undetected by conventional imaging techniques. Here we report the case of a patient with DAI and hemiparesis. Although conventional MRI revealed no abnormalities, diffusion tensor imaging (DTI) and fibre tractography (FT) revealed the lesion speculated to be responsible for hemiparesis. A 37-year-old woman fell down the stairs, sustaining a traumatic injury to the head. Subsequently, she presented with mild cognitive disorders and left hemiparesis. DTI fractional anisotropy revealed changes in the right cerebral peduncle, the right posterior limb of the internal capsule, and the right corona radiata when compared with the corresponding structures observed on the patient's left side and in healthy controls. On FT evaluation, the right corticospinal tract (CST) was poorly visualised as compared with the left CST as well as the CST in healthy controls. These findings were considered as evidence that the patient's left hemiparesis stemmed from DAI-induced axonal damage in the right CST. Thus, DTI and FT represent useful techniques for the evaluation of patients with DAI and motor disorders.

No MeSH data available.


Related in: MedlinePlus

FT of CST from the seed area around the cerebral peduncle and the target area around the precentral gyrus. The right CST of the patient with DAI (tracked line, 118; drawn line, 6) is poorly depicted as compared with the left (tracked line, 252; drawn line, 34) and that of a healthy control (R: tracked line, 242; drawn line, 34. L: tracked line, 253; drawn line, 36).
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fig2: FT of CST from the seed area around the cerebral peduncle and the target area around the precentral gyrus. The right CST of the patient with DAI (tracked line, 118; drawn line, 6) is poorly depicted as compared with the left (tracked line, 252; drawn line, 34) and that of a healthy control (R: tracked line, 242; drawn line, 34. L: tracked line, 253; drawn line, 36).

Mentions: On FT evaluation, the right CST of the patient with DAI was depicted less clearly (tracked line, 118; drawn line, 6) compared with that of the right CST of healthy controls (tracked line, 242; drawn line, 34; Figure 2). Furthermore, the depiction of the patient's right CST (tracked line, 118; drawn line, 6) was poor in comparison with that of the left CST (tracked line, 252; drawn line, 34; Figure 2).


Clinical utility of diffusion tensor imaging and fibre tractography for evaluating diffuse axonal injury with hemiparesis.

Sugiyama K, Kondo T, Suzukamo Y, Oouchida Y, Sato M, Watanabe H, Izumi S - Case Rep Med (2013)

FT of CST from the seed area around the cerebral peduncle and the target area around the precentral gyrus. The right CST of the patient with DAI (tracked line, 118; drawn line, 6) is poorly depicted as compared with the left (tracked line, 252; drawn line, 34) and that of a healthy control (R: tracked line, 242; drawn line, 34. L: tracked line, 253; drawn line, 36).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3860099&req=5

fig2: FT of CST from the seed area around the cerebral peduncle and the target area around the precentral gyrus. The right CST of the patient with DAI (tracked line, 118; drawn line, 6) is poorly depicted as compared with the left (tracked line, 252; drawn line, 34) and that of a healthy control (R: tracked line, 242; drawn line, 34. L: tracked line, 253; drawn line, 36).
Mentions: On FT evaluation, the right CST of the patient with DAI was depicted less clearly (tracked line, 118; drawn line, 6) compared with that of the right CST of healthy controls (tracked line, 242; drawn line, 34; Figure 2). Furthermore, the depiction of the patient's right CST (tracked line, 118; drawn line, 6) was poor in comparison with that of the left CST (tracked line, 252; drawn line, 34; Figure 2).

Bottom Line: DTI fractional anisotropy revealed changes in the right cerebral peduncle, the right posterior limb of the internal capsule, and the right corona radiata when compared with the corresponding structures observed on the patient's left side and in healthy controls.On FT evaluation, the right corticospinal tract (CST) was poorly visualised as compared with the left CST as well as the CST in healthy controls.Thus, DTI and FT represent useful techniques for the evaluation of patients with DAI and motor disorders.

View Article: PubMed Central - PubMed

Affiliation: Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, 2-1 Seiryo-cho, Aoba-ku, Sendai 980-8575, Japan.

ABSTRACT
Although diffuse axonal injury (DAI) frequently manifests as cognitive and/or motor disorders, abnormal brain findings are generally undetected by conventional imaging techniques. Here we report the case of a patient with DAI and hemiparesis. Although conventional MRI revealed no abnormalities, diffusion tensor imaging (DTI) and fibre tractography (FT) revealed the lesion speculated to be responsible for hemiparesis. A 37-year-old woman fell down the stairs, sustaining a traumatic injury to the head. Subsequently, she presented with mild cognitive disorders and left hemiparesis. DTI fractional anisotropy revealed changes in the right cerebral peduncle, the right posterior limb of the internal capsule, and the right corona radiata when compared with the corresponding structures observed on the patient's left side and in healthy controls. On FT evaluation, the right corticospinal tract (CST) was poorly visualised as compared with the left CST as well as the CST in healthy controls. These findings were considered as evidence that the patient's left hemiparesis stemmed from DAI-induced axonal damage in the right CST. Thus, DTI and FT represent useful techniques for the evaluation of patients with DAI and motor disorders.

No MeSH data available.


Related in: MedlinePlus