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 (5): 474-478.doi: 10.3969/j.issn.1673-5374.2013.05.011

• 原著:脑损伤修复保护与再生 • 上一篇    下一篇

Dandy-Walker畸形患者的小脑脚病变

  

  • 收稿日期:2012-11-10 修回日期:2013-01-06 出版日期:2013-02-15 发布日期:2013-02-15

Corticospinal tract recovery in a patient with traumatic transtentorial herniation

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:2012-11-10 Revised:2013-01-06 Online:2013-02-15 Published:2013-02-15
  • 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., PT.
  • 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：

小脑幕疝是引起创伤性脑损伤患者运动功能受损的原因之一。文章纳入的1例患者在创伤性脑出血后行去骨瓣减压，之后头部CT显示为左侧额颞叶出血和小脑幕疝。患者出现严重的右侧肢体瘫痪，伤后6个月肢体功能部分恢复，伤后27个月时肢体功能基本恢复正常。弥散张量纤维束成像显示，伤后1个月时，左侧大脑脚水平的皮质脊髓束中断；伤后27个月，中断的皮质脊髓束重建。说明小脑幕疝致皮质脊髓损伤患者可通过皮质脊髓束重建恢复肢体功能。

关键词: 神经再生, 神经影像学, 弥散张量纤维束成像, 弥散张量成像, 经颅磁刺激, 创伤性脑损伤, 脑出血, 小脑幕疝, 皮质脊髓束, 瘫痪, 基金资助文章, 图片文章

Abstract:

Transtentorial herniation is one of the causes of motor weakness in traumatic brain injury. In this study, we report on a patient who underwent decompressive craniectomy due to traumatic intracerebral hemorrhage. Brain CT images taken after surgery showed intracerebral hemorrhage in the left fronto-temporal lobe and left transtentorial herniation. The patient presented with severe paralysis of the right extremities at the time of intracerebral hemorrhage onset, but the limb motor function recovered partially at 6 months after onset and to nearly normal level at 27 months. Through diffusion tensor tractography, the left corticospinal tract was disrupted below the cerebral peduncle at 1 month after onset and the disrupted left corticospinal tract was reconstructed at 27 months. These findings suggest that recovery of limb motor function in a patient with traumatic transtentorial herniation can come to be true by recovery of corticospinal tract.

Key words: neural regeneration, neuroimaging, diffusion tensor imaging, diffusion tensor tractography, transcranial magnetic stimulation, traumatic brain injury, intracerebral hemorrhage, transtentorial herniation, corticospinal tract, motor paralysis, neuroimaing, grants-supported paper, photographs-containing paper, neuroregeneration