Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Taegu, Republic of Korea.
NeuroRehabilitation. 2013;33(2):257-61. doi: 10.3233/NRE-130953.
Little is known about neural recovery of an injured cingulum following brain injury. We report on a patient with brain injury who showed apparent neural recovery of an injured cingulum on follow up diffusion tensor tractography (DTT).
A 53-year-old female patient had suffered hypoxic ischemic brain injury for a period of approximately nine hours following spontaneous subarachnoid hemorrhage and intraventricular hemorrhage, and underwent coiling of a left ruptured aneurysm of the posterior communicating artery. She showed severe cognitive impairment, so that she could not be evaluated on the Mini-Mental State Examination, however, her cognition showed improvement to 21 at five months after onset and 24 at 14 months after onset on the Mini-Mental State Examination.
On seven-day DTT for the fornix in the patient, we observed a discontinuation in the left crus and thinning of the right crus. However, on 14-month DTT, the thinned right fornical crus had disappeared. Regarding the cingulum, on seven-day DTTs, discontinuations of both cingulums anterior to the genu of the corpus callosum were observed. However, on 14-month follow up DTT, the right cingulum was elongated to the right basal forebrain and no change in the discontinuation of the left cingulum was observed.
These changes observed on DTT in both cingulums appeared to indicate recovery of the injured cingulum in this patient. The results of this study may suggest a mechanism for recovery of injured cingulum following brain injury.
关于脑损伤后胼胝体损伤的神经恢复知之甚少。我们报告了一例脑损伤患者，在随访的弥散张量跟踪成像（DTT）中显示出明显的胼胝体损伤神经恢复。
一名 53 岁女性患者在自发性蛛网膜下腔出血和脑室出血后约 9 小时发生缺氧缺血性脑损伤，并接受了左侧后交通动脉破裂动脉瘤的线圈栓塞。她表现出严重的认知障碍，以至于无法在 Mini-Mental State Examination 上进行评估，但她的认知能力在发病后 5 个月时提高到 21，在发病后 14 个月时提高到 24。
在该患者的穹窿 7 天 DTT 中，我们观察到左侧穹窿体中断和右侧穹窿体变薄。然而，在 14 个月的 DTT 中，变薄的右侧穹窿体已经消失。关于胼胝体，在 7 天的 DTTs 中，观察到胼胝体前到胼胝体膝部的双侧胼胝体中断。然而，在 14 个月的随访 DTT 中，右侧胼胝体向右侧基底前脑延伸，左侧胼胝体中断无变化。
在 DTT 中观察到的这两个胼胝体的变化似乎表明该患者的损伤胼胝体得到了恢复。本研究的结果可能提示脑损伤后损伤的胼胝体恢复的机制。
