Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Namku, Taegu, Republic of Korea.
NeuroRehabilitation. 2013;32(2):305-9. doi: 10.3233/NRE-130848.
The main function of the corticospinal tract (CST) is control of the distal musculature used for fine movements, in contrast, the corticoreticular pathway (CRP) innervates the proximal and axial musculature. We report on a patient with an intracerebral hemorrhage (ICH) who showed recovery of an injured CST and an injured CRP by diffusion tensor tractography (DTT). The patient, a 38-year-old man, presented with severe paralysis of the right upper and lower extremities due to a spontaneous ICH in the left corona radiata and basal ganglia. When he started rehabilitation at 3 weeks after onset, he showed more severe weakness in the proximal joints (shoulder and hip joints) than distal joints (hand and ankle joints). This proximal weakness improved rapidly in parallel with distal weakness over 3 weeks of rehabilitation. DTT performed at 3 and 6 weeks post-ICH revealed that a thin left CST observed at 3 weeks thickened at 6 weeks, and that a discontinuation of the left CRP at the midbrain level at 3 weeks was restored at 6 weeks. In addition, the track volumes of the left CST and CRP increased from 221 and 244 at 3 weeks to 725 and 625 at 6 weeks. In conclusion, we demonstrated the recovery of an injured CST and an injured CRP in a patient with ICH.
皮质脊髓束（CST）的主要功能是控制用于精细运动的远端肌肉，相比之下，皮质网状束（CRP）支配近端和轴性肌肉。我们报告了一例脑出血（ICH）患者，通过弥散张量成像（DTT）显示损伤的 CST 和 CRP 得到恢复。该患者为 38 岁男性，因左侧放射冠和基底节区自发性 ICH 导致右上、下肢严重瘫痪。发病后 3 周开始康复时，近端关节（肩部和髋关节）的无力程度比远端关节（手部和踝关节）更严重。近端无力在 3 周的康复过程中与远端无力一起迅速改善。在发病后 3 周和 6 周进行的 DTT 显示，3 周时观察到的左侧 CST 变薄，6 周时变厚，3 周时在中脑水平中断的左侧 CRP 在 6 周时恢复。此外，左侧 CST 和 CRP 的轨迹体积从 3 周时的 221 和 244 增加到 6 周时的 725 和 625。总之，我们在一名 ICH 患者中证明了损伤的 CST 和 CRP 的恢复。
