Clinical Utility of Diffusion Tensor Imaging and Fibre Tractography for Evaluating Diffuse Axonal Injury with Hemiparesis

Although diffuse axonal injury (DAI) frequently manifests as cognitive and/or motor disorders, abnormal brain findings are generally undetected by conventional imaging techniques. Here we report the case of a patient with DAI and hemiparesis. Although conventional MRI revealed no abnormalities, diff...

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Main Authors: Ken Sugiyama, Takeo Kondo, Yoshimi Suzukamo, Yutaka Oouchida, Mari Sato, Hiroshi Watanabe, Shin-Ichi Izumi
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:Case Reports in Medicine
Online Access:http://dx.doi.org/10.1155/2013/321496
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author Ken Sugiyama
Takeo Kondo
Yoshimi Suzukamo
Yutaka Oouchida
Mari Sato
Hiroshi Watanabe
Shin-Ichi Izumi
author_facet Ken Sugiyama
Takeo Kondo
Yoshimi Suzukamo
Yutaka Oouchida
Mari Sato
Hiroshi Watanabe
Shin-Ichi Izumi
author_sort Ken Sugiyama
collection DOAJ
description Although diffuse axonal injury (DAI) frequently manifests as cognitive and/or motor disorders, abnormal brain findings are generally undetected by conventional imaging techniques. Here we report the case of a patient with DAI and hemiparesis. Although conventional MRI revealed no abnormalities, diffusion tensor imaging (DTI) and fibre tractography (FT) revealed the lesion speculated to be responsible for hemiparesis. A 37-year-old woman fell down the stairs, sustaining a traumatic injury to the head. Subsequently, she presented with mild cognitive disorders and left hemiparesis. DTI fractional anisotropy revealed changes in the right cerebral peduncle, the right posterior limb of the internal capsule, and the right corona radiata when compared with the corresponding structures observed on the patient’s left side and in healthy controls. On FT evaluation, the right corticospinal tract (CST) was poorly visualised as compared with the left CST as well as the CST in healthy controls. These findings were considered as evidence that the patient’s left hemiparesis stemmed from DAI-induced axonal damage in the right CST. Thus, DTI and FT represent useful techniques for the evaluation of patients with DAI and motor disorders.
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publishDate 2013-01-01
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spelling doaj-art-772678f1fff442dab934e7111bdc8cbb2025-08-20T02:07:34ZengWileyCase Reports in Medicine1687-96271687-96352013-01-01201310.1155/2013/321496321496Clinical Utility of Diffusion Tensor Imaging and Fibre Tractography for Evaluating Diffuse Axonal Injury with HemiparesisKen Sugiyama0Takeo Kondo1Yoshimi Suzukamo2Yutaka Oouchida3Mari Sato4Hiroshi Watanabe5Shin-Ichi Izumi6Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, 2-1 Seiryo-cho, Aoba-ku, Sendai 980-8575, JapanDepartment of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, 2-1 Seiryo-cho, Aoba-ku, Sendai 980-8575, JapanDepartment of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, 2-1 Seiryo-cho, Aoba-ku, Sendai 980-8575, JapanDepartment of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, 2-1 Seiryo-cho, Aoba-ku, Sendai 980-8575, JapanDepartment of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, 2-1 Seiryo-cho, Aoba-ku, Sendai 980-8575, JapanDivision of Physical Medicine and Rehabilitation, Tohoku Employees’ Pension Welfare Hospital, 1-12-1 Fukumuro, Miyagino-ku, Sendai 983-8512, JapanDepartment of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, 2-1 Seiryo-cho, Aoba-ku, Sendai 980-8575, JapanAlthough diffuse axonal injury (DAI) frequently manifests as cognitive and/or motor disorders, abnormal brain findings are generally undetected by conventional imaging techniques. Here we report the case of a patient with DAI and hemiparesis. Although conventional MRI revealed no abnormalities, diffusion tensor imaging (DTI) and fibre tractography (FT) revealed the lesion speculated to be responsible for hemiparesis. A 37-year-old woman fell down the stairs, sustaining a traumatic injury to the head. Subsequently, she presented with mild cognitive disorders and left hemiparesis. DTI fractional anisotropy revealed changes in the right cerebral peduncle, the right posterior limb of the internal capsule, and the right corona radiata when compared with the corresponding structures observed on the patient’s left side and in healthy controls. On FT evaluation, the right corticospinal tract (CST) was poorly visualised as compared with the left CST as well as the CST in healthy controls. These findings were considered as evidence that the patient’s left hemiparesis stemmed from DAI-induced axonal damage in the right CST. Thus, DTI and FT represent useful techniques for the evaluation of patients with DAI and motor disorders.http://dx.doi.org/10.1155/2013/321496
spellingShingle Ken Sugiyama
Takeo Kondo
Yoshimi Suzukamo
Yutaka Oouchida
Mari Sato
Hiroshi Watanabe
Shin-Ichi Izumi
Clinical Utility of Diffusion Tensor Imaging and Fibre Tractography for Evaluating Diffuse Axonal Injury with Hemiparesis
Case Reports in Medicine
title Clinical Utility of Diffusion Tensor Imaging and Fibre Tractography for Evaluating Diffuse Axonal Injury with Hemiparesis
title_full Clinical Utility of Diffusion Tensor Imaging and Fibre Tractography for Evaluating Diffuse Axonal Injury with Hemiparesis
title_fullStr Clinical Utility of Diffusion Tensor Imaging and Fibre Tractography for Evaluating Diffuse Axonal Injury with Hemiparesis
title_full_unstemmed Clinical Utility of Diffusion Tensor Imaging and Fibre Tractography for Evaluating Diffuse Axonal Injury with Hemiparesis
title_short Clinical Utility of Diffusion Tensor Imaging and Fibre Tractography for Evaluating Diffuse Axonal Injury with Hemiparesis
title_sort clinical utility of diffusion tensor imaging and fibre tractography for evaluating diffuse axonal injury with hemiparesis
url http://dx.doi.org/10.1155/2013/321496
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