Recovery of an injured corticoreticular pathway via transcallosal fibers in a patient with intracerebral hemorrhage
1 Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University 317–1, Daemyungdong, Namku, Taegu 705-717, Republic of Korea
2 Department of Physical Therapy, College of Health Sciences, Dankook University, 119, Dandae-ro, Dongnam-gu, Cheonan-si, Chungnam 330-714, Republic of Korea
BMC Neurology 2014, 14:108 doi:10.1186/1471-2377-14-108Published: 19 May 2014
Several studies have reported on injury of the corticoreticular pathway (CRP), however, little is known about the mechanism for recovery of an injured CRP. We report on a patient with intracerebral hemorrhage (ICH) who showed recovery of an injured CRP via transcallosal fibers, which was demonstrated by diffusion tensor tractography (DTT).
A 67-year-old man presented with complete paralysis (Medical Research Council: 0/5) of the left extremities at the onset of a right putaminal hemorrhage. At six weeks after onset, he presented with more severe weakness of proximal joint muscles than distal joint muscles (right shoulder abductor; 2−, finger extensor; 3+, hip flexor; 2+, ankle dorsiflexor; 3). Although his right hemiplegia had recovered well, he consistently showed more severe proximal weakness (right shoulder abductor; 3, finger extensor; 4, hip flexor; 3+, ankle dorsiflexor; 4) until 16 weeks after onset. On both six- and 16-week DTTs, in the left (affected) hemisphere, the CRP showed severe narrowing with discontinuation of the anterior fibers at the corona radiata on six-week DTT, however, the discontinued anterior fibers of the CRP were connected to the right cerebral cortex via transcallosal fibers on 16-week DTT.
We demonstrated recovery of an injured CRP via transcallosal fibers in a patient with ICH. We believe that this might be a mechanism for recovery of an injured CRP.