Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Taegu, Republic of Korea.
J Rehabil Med. 2010 Nov;42(10):979-81. doi: 10.2340/16501977-0603.
The cingulum and fornix are important structures for memory function. Using follow-up diffusion tensor tractography in a patient with traumatic brain injury we found degeneration of the cingulum and fornix.
An 18-year-old male who had had a traffic accident underwent conservative management for diffuse axonal injury. Brain magnetic resonance imaging showed an encephalomalactic lesion in the posterior portion of the corpus callosum. The patient had severe cognitive problems at 3 months after onset. However, while his intelligence had improved, his memory impairment had been aggravated at 14 months from onset.
On the first diffusion tensor tractographies, the integrity of both corticospinal tracts, right cingulum, and left fornix were preserved; however, compared with controls, there were disruptions in both ends of the left cingulum and right fornical crus. On the second diffusion tensor tractographies, both the cingulum and fornix showed severe degeneration, although the integrities of both corticospinal tracts were well preserved.
We conclude that patients with memory impairment following traumatic brain injury should be evaluated using diffusion tensor imaging. In addition, follow-up diffusion tensor imaging may be necessary in patients with sustained memory impairment.
穹窿和扣带是与记忆功能相关的重要结构。我们通过对创伤性脑损伤患者进行随访扩散张量追踪，发现了穹窿和扣带的变性。
一名 18 岁男性因交通事故接受了弥漫性轴索损伤的保守治疗。脑部磁共振成像显示胼胝体后部有一个脑白质软化病灶。患者在发病后 3 个月出现严重认知问题。然而，虽然他的智力有所改善，但发病后 14 个月时他的记忆障碍加重了。
第一次扩散张量追踪时，皮质脊髓束、右侧扣带和左侧穹窿的完整性均得以保留；然而，与对照组相比，左侧扣带的两端和右侧穹窿脚都出现了中断。第二次扩散张量追踪时，扣带和穹窿都显示出严重的退化，尽管皮质脊髓束的完整性都很好。
我们的结论是，创伤性脑损伤后有记忆障碍的患者应使用弥散张量成像进行评估。此外，对于持续存在记忆障碍的患者，可能需要进行随访扩散张量成像。
