Jang Sung Ho, Kim Seong Ho, Cho Soo Ho, Choi Byung Yun, Cho Yun Woo
Department of Physical Medicine and Rehabilitation, School of Medicine, Yeungnam University 317-1, Daemyungdong, Namku, Taegu, 705-717, Republic of Korea.
NeuroRehabilitation. 2007;22(2):141-5.
Little is known about the mechanism of motor recovery for patients with intracerebral hemorrhage (ICH). We attempted to demonstrate the motor recovery mechanism in a hemiparetic patient with ICH using diffusion tensor tractography (DTT), transcranial magnetic stimulation (TMS), and functional MRI (fMRI).
A 37-year-old female patient and twelve age-matched control subjects were evaluated. The patient presented with complete paralysis of the left extremities, which occurred at the onset of a spontaneous ICH in the left corona radiata and basal ganglia. Over the 16 month period following onset, motor function of the affected extremities slowly recovered to a nearly normal state. Three longitudinal evaluations (at 1 month, 4 months, and 16 months from onset) were conducted for the patient.
DTT showed that the origin of the corticospinal tract (CST) had changed from the posterior parietal cortex, primary sensory cortex, and primary motor cortex. Additionally, TMS and fMRI demonstrated the recovery process of the damaged lateral CST.
It seems that, in this patient, the affected motor function was recovered through the normalization process of the damaged lateral CST of the affected hemisphere. We conclude that this may be one of various motor recovery mechanisms for patients with ICH. Process of the damaged lateral CST.
关于脑出血（ICH）患者运动恢复机制的了解甚少。我们试图通过弥散张量纤维束成像（DTT）、经颅磁刺激（TMS）和功能磁共振成像（fMRI）来阐明一名ICH偏瘫患者的运动恢复机制。
对一名37岁女性患者和12名年龄匹配的对照对象进行了评估。该患者在左侧放射冠和基底节区自发性ICH发作时出现左侧肢体完全瘫痪。在发病后的16个月内，患侧肢体的运动功能缓慢恢复至接近正常状态。对该患者进行了三次纵向评估（发病后1个月、4个月和16个月）。
DTT显示皮质脊髓束（CST）的起源已从顶叶后皮质、初级感觉皮质和初级运动皮质发生改变。此外，TMS和fMRI显示了受损的外侧CST的恢复过程。
在该患者中，似乎患侧运动功能是通过患侧半球受损外侧CST的正常化过程得以恢复。我们得出结论，这可能是ICH患者多种运动恢复机制之一。受损外侧CST的过程。
