Proximal weakness due to injury of the corticoreticular pathway in a patient with traumatic brain injury
- Proximal weakness due to injury of the corticoreticular pathway in a patient with traumatic brain injury
- 장성호; 여상석; 김성호
- DIFFUSE AXONAL INJURY; PREMOTOR CORTEX; CORTICOSPINAL TRACT; MAGNETIC STIMULATION; STROKE PATIENTS; MOTOR RECOVERY; GAIT; WALKING; CAT
- Issue Date
- IOS PRESS
- NEUROREHABILITATION, v.32, no.3, pp.665 - 669
- BACKGROUND: The corticoreticular pathway (CRP) innervates the proximal muscles of extremities and axial muscles; therefore, it is involved in postural control and gait. We report on a patient who exhibited proximal weakness due to a CRP injury, which was evaluated using diffusion tensor tractography (DTT). METHODS: A 62-year-old male patient who had been injured in a traffic accident underwent conservative management for a contusional hemorrhage in the right frontotemporal lobes, and a subdural and epidural hematoma in the right temporoparietal lobes. The patient exhibited right proximal weakness (shoulder: 3(+), hip: 3(+)) at two weeks after onset. Findings on brain MRI revealed encephalomalactic lesions in both frontal lobes. RESULTS: Findings on DTT of the left CRP showed discontinuation at the midbrain level; in contrast, the integrities of the corticospinal tract in both hemispheres were maintained from the cerebral cortex to the medulla along the known pathway of the corticospinal tract. CONCLUSION: The proximal weakness of the right shoulder and hip observed in this patient appeared to be attributed to injury of the left CRP.
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