Corticospinal Tract Compression by Hematoma in a Patient with Intracerebral Hemorrhage: A Diffusion Tensor Tractography and Functional MRI Study.
10.3349/ymj.2006.47.1.135
- Author:
Sung Ho JANG
1
;
Yong Hyun KWON
;
Mi Young LEE
;
Sang Ho AHN
;
Joong Hwi KIM
;
Dong Hoon JEONG
;
Byung Yeun CHOI
;
Dong Gyu LEE
Author Information
1. Department of Physical Medicine and Rehabilitation, School of Medicine, Yeungnam University Daegu, Korea. kwonpt@lycos.co.kr
- Publication Type:Case Report ; Research Support, Non-U.S. Gov't
- Keywords:
Functional MRI;
diffusion tensor tractography;
corticospinal tract;
stroke
- MeSH:
Spinal Cord Compression/complications/*diagnosis/pathology;
Pyramidal Tracts/*pathology;
*Magnetic Resonance Imaging;
Humans;
Hematoma/complications/*diagnosis/pathology;
Female;
Diffusion Magnetic Resonance Imaging/*methods;
Cerebral Hemorrhage/complications/*diagnosis/pathology;
Adult
- From:Yonsei Medical Journal
2006;47(1):135-139
- CountryRepublic of Korea
- Language:English
-
Abstract:
The purpose of this study was to demonstrate corticospinal tract compression that was due to a hematoma by using diffusion tensor tractography (DTT) and functional MRI (fMRI) in a patient with an intracerebral hemorrhage (ICH). A 23-year-old right-handed woman presented with severe paralysis of her right extremities at the onset of a spontaneous ICH. Over the first three days from onset, the motor function of the affected upper and lower extremities rapidly recovered to the extent that she was able to overcome applied resistance to the affected limbs, and her limbs regained normal function 3 weeks after onset. The tract of the right hemisphere originated from the primary sensori-motor cortex (SM1) and it passed through the known corticospinal tract pathway. However, the tract of the left hemisphere was similar to that of the right hemisphere except that it was displaced to the antero-medial side by the hematoma at the cerebral peduncle. Only the contralateral SM1 area centered on the precentral knob was activated during affected (right) or unaffected (left) hand movements, respectively. In conclusion, fMRI and DTT demonstrated a corticospinal tract compression due to hematoma in this patient. We conclude that the combined use of these two modalities appears to improve the accuracy of investigating the state of the corticospinal tract.
