Decreased thalamic metabolism without thalamic magnetic resonance imaging abnormalities following shearing injury to the substantia nigra. 2002

Akira Nakamizo, and Takanori Inamura, and Toshiyuki Amano, and Satoshi Inoha, and Kentaro Tokuda, and Osamu Yasuda, and Kiyonobu Ikezaki, and Masashi Fukui
Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. nakamizo@ns.med.kyushu-u.ac.jp

A 36-year-old man had fallen about 8 metres. Radiographs showed a mandibular fracture, indicating rotatory force applied to the head. Fluid-attenuated inversion recovery (FLAIR) imaging showed hyperintensity in both medial temporal lobes, left medial midbrain, right midbrain including cerebral peduncle, left pulvinar, left external capsule, fornix, splenium of corpus callosum, and deep white matter of both frontal lobes. Quantitative [(18)F]fluorodeoxyglucose (FDG)-positron emission tomography (PET) indicated markedly suppressed glucose metabolism in the left thalamus but not markedly in the striatum. At that time the neurologic examination demonstrated complete left hemiparesis, severe rigidity of the right upper extremity, and inability to move the right hand and fingers. Levodopa at 300-600 mg/day improved movement of the fingers, decreased the rigidity in the extremity, and lessened the metabolic abnormality. Diminished metabolism in the left thalamus may have contributed to symptoms. The case illustrates the usefulness of PET in disclosing symptom causing abnormalities not detected by magnetic resonance imaging.

UI MeSH Term Description Entries
D008279 Magnetic Resonance Imaging Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. Chemical Shift Imaging,MR Tomography,MRI Scans,MRI, Functional,Magnetic Resonance Image,Magnetic Resonance Imaging, Functional,Magnetization Transfer Contrast Imaging,NMR Imaging,NMR Tomography,Tomography, NMR,Tomography, Proton Spin,fMRI,Functional Magnetic Resonance Imaging,Imaging, Chemical Shift,Proton Spin Tomography,Spin Echo Imaging,Steady-State Free Precession MRI,Tomography, MR,Zeugmatography,Chemical Shift Imagings,Echo Imaging, Spin,Echo Imagings, Spin,Functional MRI,Functional MRIs,Image, Magnetic Resonance,Imaging, Magnetic Resonance,Imaging, NMR,Imaging, Spin Echo,Imagings, Chemical Shift,Imagings, Spin Echo,MRI Scan,MRIs, Functional,Magnetic Resonance Images,Resonance Image, Magnetic,Scan, MRI,Scans, MRI,Shift Imaging, Chemical,Shift Imagings, Chemical,Spin Echo Imagings,Steady State Free Precession MRI
D008297 Male Males
D008337 Mandibular Fractures Fractures of the lower jaw. Fracture, Mandibular,Fractures, Mandibular,Mandibular Fracture
D001930 Brain Injuries Acute and chronic (see also BRAIN INJURIES, CHRONIC) injuries to the brain, including the cerebral hemispheres, CEREBELLUM, and BRAIN STEM. Clinical manifestations depend on the nature of injury. Diffuse trauma to the brain is frequently associated with DIFFUSE AXONAL INJURY or COMA, POST-TRAUMATIC. Localized injuries may be associated with NEUROBEHAVIORAL MANIFESTATIONS; HEMIPARESIS, or other focal neurologic deficits. Brain Lacerations,Acute Brain Injuries,Brain Injuries, Acute,Brain Injuries, Focal,Focal Brain Injuries,Injuries, Acute Brain,Injuries, Brain,Acute Brain Injury,Brain Injury,Brain Injury, Acute,Brain Injury, Focal,Brain Laceration,Focal Brain Injury,Injuries, Focal Brain,Injury, Acute Brain,Injury, Brain,Injury, Focal Brain,Laceration, Brain,Lacerations, Brain
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000058 Accidental Falls Falls due to slipping or tripping which may result in injury. Falls, Accidental,Falling,Falls,Slip and Fall,Accidental Fall,Fall and Slip,Fall, Accidental
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D013378 Substantia Nigra The black substance in the ventral midbrain or the nucleus of cells containing the black substance. These cells produce DOPAMINE, an important neurotransmitter in regulation of the sensorimotor system and mood. The dark colored MELANIN is a by-product of dopamine synthesis. Nigra, Substantia,Nigras, Substantia,Substantia Nigras
D013788 Thalamus Paired bodies containing mostly GRAY MATTER and forming part of the lateral wall of the THIRD VENTRICLE of the brain. Thalamencephalon,Thalamencephalons
D014055 Tomography, Emission-Computed Tomography using radioactive emissions from injected RADIONUCLIDES and computer ALGORITHMS to reconstruct an image. CAT Scan, Radionuclide,CT Scan, Radionuclide,Computerized Emission Tomography,Radionuclide Tomography, Computed,Scintigraphy, Computed Tomographic,Tomography, Radionuclide-Computed,Computed Tomographic Scintigraphy,Emission-Computed Tomography,Radionuclide Computer-Assisted Tomography,Radionuclide Computerized Tomography,Radionuclide-Computed Tomography,Radionuclide-Emission Computed Tomography,Tomography, Computerized Emission,CAT Scans, Radionuclide,CT Scans, Radionuclide,Computed Radionuclide Tomography,Computed Tomography, Radionuclide-Emission,Computer-Assisted Tomographies, Radionuclide,Computer-Assisted Tomography, Radionuclide,Computerized Tomography, Radionuclide,Emission Computed Tomography,Emission Tomography, Computerized,Radionuclide CAT Scan,Radionuclide CAT Scans,Radionuclide CT Scan,Radionuclide CT Scans,Radionuclide Computed Tomography,Radionuclide Computer Assisted Tomography,Radionuclide Computer-Assisted Tomographies,Radionuclide Emission Computed Tomography,Scan, Radionuclide CAT,Scan, Radionuclide CT,Scans, Radionuclide CAT,Scans, Radionuclide CT,Tomographic Scintigraphy, Computed,Tomographies, Radionuclide Computer-Assisted,Tomography, Computed Radionuclide,Tomography, Emission Computed,Tomography, Radionuclide Computed,Tomography, Radionuclide Computer-Assisted,Tomography, Radionuclide Computerized,Tomography, Radionuclide-Emission Computed

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