Jang Sung Ho, Yang Dong Suk, Lee Jun
Departments of Physical Medicine and Rehabilitation, School of Medicine, Yeungnam University, Taegu, Republic of Korea.
Am J Phys Med Rehabil. 2009 Mar;88(3):256-8. doi: 10.1097/PHM.0b013e31818dfbec.
Diffusion tensor tractography allows the visualization of the corticospinal tract (CST). In the current study, we attempted to demonstrate the preservation of the integrity of the CST within an infarct in a hemiparetic patient with a medulla infarct. A 76-yr-old male patient showed severe paralysis of the left extremities at stroke onset. Over the 4 mos following onset, motor functions of the affected extremities rapidly recovered to a normal state. On the diffusion tensor tractography taken at 1 wk after onset, the tract of the both hemispheres descended through the known CST pathway. Notably, the tract of the affected (right) hemisphere descended through the anterior portion of the infarct in the medulla. The motor-evoked potential obtained from the affected (left) hand muscle had the characteristics of the CST. In conclusion, we demonstrated that the integrity of CST had been spared in the anterior portion of the medulla infarct by using diffusion tensor tractography and transcranial magnetic stimulation.
扩散张量纤维束成像可实现皮质脊髓束（CST）的可视化。在本研究中，我们试图在一名患有延髓梗死的偏瘫患者的梗死灶内证明CST完整性的保留情况。一名76岁男性患者在中风发作时出现左侧肢体严重瘫痪。在发病后的4个月内，患侧肢体的运动功能迅速恢复至正常状态。在发病1周后进行的扩散张量纤维束成像检查中，双侧半球的纤维束均通过已知的CST路径下行。值得注意的是，患侧（右侧）半球的纤维束通过延髓梗死灶的前部下行。从患侧（左侧）手部肌肉获得的运动诱发电位具有CST的特征。总之，我们通过扩散张量纤维束成像和经颅磁刺激证明，延髓梗死灶前部的CST完整性得以保留。
