中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2013, Vol. 8 ›› Issue (1): 90-94.doi: 10.3969/j.issn.1673-5374.2013.01.012

• 原著:脑损伤修复保护与再生 • 上一篇    

创伤性脑损伤患者的锥体束变异

  

  • 收稿日期:2012-07-07 修回日期:2012-12-06 出版日期:2013-01-05 发布日期:2013-01-05

Motor recovery via aberrant pyramidal tract in a patient with traumatic brain injuryA diffusion tensor tractography study

Sang Seok Yeo, Sung Ho Jang   

  1. Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daegu 705-717, Republic of Korea
  • Received:2012-07-07 Revised:2012-12-06 Online:2013-01-05 Published:2013-01-05
  • Contact: Sung Ho Jang, M.D., Professor, Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, 317-1, Daemyungdong, Namku, Daegu, 705-717, Republic of Korea, strokerehab@hanmail.net.
  • About author:Sang Seok Yeo, M.S.
  • Supported by:

    This study was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology, No. 2012R1A1A4A01001873.

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摘要：

变异锥体束是穿过脑干内侧丘系的锥体束的分支。1例21岁的男性患者由于左侧放射冠的创伤性脑出血导致右侧肢体瘫痪。伤后10个月，该患者的运动功能几乎恢复至正常水平。13个月后的左侧大脑半球的弥散张量纤维束成像显示，脑桥水平的锥体束出现中断，但同时也发现了变异锥体束，其起源于初级运动皮质和辅助运动区，穿过放射冠下行，然后穿过内囊后肢和中脑的内侧丘系，进入脑桥延髓结合部的锥体束区。伤后13个月，经颅磁刺激检测到双侧大脑半球均可引出运动诱发电位。说明创伤性脑损伤患者通过变异锥体束恢复了运动功能。

关键词: 神经再生, 神经影像, 弥散张量成像, 经颅磁刺激, 锥体束, 变异锥体束, 运动麻痹, 运动功能, 创伤性脑损伤, 头部创伤, 脑出血, 基金资助文章, 图片文章

Abstract:

The aberrant pyramidal tract is the collateral pathway of the pyramidal tract through the medial lemniscus in the brainstem. A 21-year-old man presented with right hemiparesis due to a traumatic intracerebral hemorrhage in the left corona radiata. His motor function recovered almost to the normal state at 10 months after onset. Through diffusion tensor tractography, the pyramidal tract in the affected (left) hemisphere showed discontinuation at the pontine level at 13 months after onset. An aberrant pyramidal tract was observed, which originated from the primary motor cortex and the supplementary motor area and descended through the corona radiata, then through the posterior limb of the internal capsule and the medial lemniscus pathway from the midbrain to the pons, finally entered into the pyramidal tract area at the pontomedullary junction. It suggests that the motor functions of the right extremities in this patient had recovered by this aberrant pyramidal tract.

Key words: neural regeneration, neuroimaging, diffusion tensor imaging, diffusion tensor tractography, transcranial magnetic stimulation, pyramidal tract, aberrant pyramidal tract, motor paralysis, motor recovery, traumatic brain injury, head trauma, intracerebral hemorrhage, grant-supported paper, photographs-containing paper, neuroregeneration