Delayed gait disturbance due to injury of the corticoreticular pathway in a patient with mild traumatic brain injury. 2014

Hyeok Gyu Kwon, and Sung Ho Jang
Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University , Namku, Taegu , Republic of Korea.

BACKGROUND Many studies have demonstrated neural injury in patients with mild traumatic brain injury, using diffusion tensor imaging (DTI). However, knowledge regarding injury of the corticoreticular pathway (CRP) is limited. This study reports on a patient with mild TBI who showed delayed gait disturbance due to injury of the CRP following head trauma, which was demonstrated by DTI. METHODS A 14-year-old female patient suffered from an in-car accident: her head was hit with the backseat during hyperextension after flexion movement when her sedan was struck by another sedan from behind. She showed mild quadriparesis after onset. At 29 days after onset, she noted gait disturbance and aggravated quadriparesis with more severe weakness of the proximal joints. RESULTS No abnormality was observed on brain MRI and electromyography study performed at 10 weeks after onset. Both CRPs were discontinued at the midbrain level on 10-week DTI. CONCLUSIONS It appears that the proximal weakness of this patient was attributed to injury of both CRPs following head trauma. It is assumed that the mild weakness at the onset of head trauma was caused by the primary traumatic axonal injury and the aggravated weakness that started from 29 days might be ascribed to the secondary traumatic axonal injury.

UI MeSH Term Description Entries
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
D002540 Cerebral Cortex The thin layer of GRAY MATTER on the surface of the CEREBRAL HEMISPHERES that develops from the TELENCEPHALON and folds into gyri and sulci. It reaches its highest development in humans and is responsible for intellectual faculties and higher mental functions. Allocortex,Archipallium,Cortex Cerebri,Cortical Plate,Paleocortex,Periallocortex,Allocortices,Archipalliums,Cerebral Cortices,Cortex Cerebrus,Cortex, Cerebral,Cortical Plates,Paleocortices,Periallocortices,Plate, Cortical
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000344 Afferent Pathways Nerve structures through which impulses are conducted from a peripheral part toward a nerve center. Afferent Pathway,Pathway, Afferent,Pathways, Afferent
D018908 Muscle Weakness A vague complaint of debility, fatigue, or exhaustion attributable to weakness of various muscles. The weakness can be characterized as subacute or chronic, often progressive, and is a manifestation of many muscle and neuromuscular diseases. (From Wyngaarden et al., Cecil Textbook of Medicine, 19th ed, p2251) Muscular Weakness,Muscle Weaknesses,Muscular Weaknesses,Weakness, Muscle,Weakness, Muscular,Weaknesses, Muscle,Weaknesses, Muscular
D020233 Gait Disorders, Neurologic Gait abnormalities that are a manifestation of nervous system dysfunction. These conditions may be caused by a wide variety of disorders which affect motor control, sensory feedback, and muscle strength including: CENTRAL NERVOUS SYSTEM DISEASES; PERIPHERAL NERVOUS SYSTEM DISEASES; NEUROMUSCULAR DISEASES; or MUSCULAR DISEASES. Ambulation Disorders, Neurologic,Charcot Gait,Charcot's Gait,Duck Gait,Gait Disorder, Sensorimotor,Gait Dysfunction, Neurologic,Gait, Athetotic,Gait, Broadened,Gait, Drop Foot,Gait, Festinating,Gait, Frontal,Gait, Hemiplegic,Gait, Hysterical,Gait, Reeling,Gait, Rigid,Gait, Scissors,Gait, Shuffling,Gait, Spastic,Gait, Stumbling,Gait, Unsteady,Gait, Widebased,Locomotion Disorders, Neurologic,Marche a Petit Pas,Neurologic Ambulation Disorders,Neurologic Locomotion Disorders,Rapid Fatigue of Gait,Sensorimotor Gait Disorder,Ambulation Disorder, Neurologic,Athetotic Gait,Broadened Gait,Charcot Gaits,Charcots Gait,Drop Foot Gait,Festinating Gait,Foot Gait, Drop,Frontal Gait,Gait Disorder, Neurologic,Gait Disorders, Sensorimotor,Gait Dysfunctions, Neurologic,Gait, Charcot,Gait, Charcot's,Gait, Duck,Gaits, Charcot,Hemiplegic Gait,Hysterical Gait,Locomotion Disorder, Neurologic,Neurologic Ambulation Disorder,Neurologic Gait Disorder,Neurologic Gait Disorders,Neurologic Gait Dysfunction,Neurologic Gait Dysfunctions,Neurologic Locomotion Disorder,Reeling Gait,Rigid Gait,Scissors Gait,Sensorimotor Gait Disorders,Shuffling Gait,Shuffling Gaits,Spastic Gait,Stumbling Gait,Unsteady Gait,Widebased Gait
D038524 Diffusion Magnetic Resonance Imaging A diagnostic technique that incorporates the measurement of molecular diffusion (such as water or metabolites) for tissue assessment by MRI. The degree of molecular movement can be measured by changes of apparent diffusion coefficient (ADC) with time, as reflected by tissue microstructure. Diffusion MRI has been used to study BRAIN ISCHEMIA and tumor response to treatment. Magnetic Resonance Imaging, Diffusion,Diffusion MRI,Diffusion Weighted MRI,Diffusion MRIs,MRI, Diffusion Weighted

Related Publications

Hyeok Gyu Kwon, and Sung Ho Jang
November 2016, American journal of physical medicine & rehabilitation,
Hyeok Gyu Kwon, and Sung Ho Jang
January 2011, The Journal of neuropsychiatry and clinical neurosciences,
Hyeok Gyu Kwon, and Sung Ho Jang
January 2020, Global pediatric health,
Hyeok Gyu Kwon, and Sung Ho Jang
December 2010, Continuum (Minneapolis, Minn.),
Hyeok Gyu Kwon, and Sung Ho Jang
January 2022, Neuroimmunomodulation,
Hyeok Gyu Kwon, and Sung Ho Jang
January 2021, Journal of neurotrauma,
Hyeok Gyu Kwon, and Sung Ho Jang
February 2020, Human movement science,
Copied contents to your clipboard!