Annals of Rehabilitation Medicine  2017;41(1):153-157

doi:10.5535/arm.2017.41.1.153

Diagnostic Challenge of Diffusion Tensor Imaging in a Patient With Hemiplegia After Traumatic Brain Injury.

Hye Eun SHIN 1 ; Hoon Chang SUH ; Si Hyun KANG ; Kyung Mook SEO ; Don Kyu KIM ; Hae Won SHIN

Affiliations

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Keywords

Diffusion tensor imaging; Traumatic brain injuries; Corticospinal tract

Country

Republic of Korea

Language

English

Abstract

A 51-year-old man showed hemiplegia on his right side after a traumatic brain injury (TBI). On initial brain computed tomography (CT) scan, an acute subdural hemorrhage in the right cerebral convexity and severe degrees of midline shifting and subfalcine herniation to the left side were evident. On follow-up brain magnetic resonance imaging (MRI), there were multiple microhemorrhages in the left parietal and occipital subcortical regions. To explain the occurrence of right hemiplegia after brain damage which dominantly on the right side of brain, we used diffusion tensor imaging (DTI) to reconstruct the corticospinal tract (CST), which showed nearly complete injury on the left CST. We also performed motor-evoked potentials, and stimulation of left motor cortex evoked no response on both sides of upper extremity. We report a case of patient with hemiplegia after TBI and elucidation of the case by DTI rather than CT and MRI.