Jang Sung Ho, Kwon Young Hyeon
Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Namku, Daegu, Republic of Korea.
Medicine (Baltimore). 2017 Nov;96(45):e8436. doi: 10.1097/MD.0000000000008436.
We report on a patient who showed neural reorganization between injured cingula and the brainstem cholinergic nuclei following cerebral concussion.
The main concern of the patient is memory impairment.
Cerebral concussion.
When she visited our hospital at 2 years after onset, cognitive function was evaluated using 2 scales; the Wechsler Intelligence Scale, and the Seoul neuropsychological screening battery: total IQ 97, verbal immediate recall 5.70 percentile, visual immediate recall 30.75 percentile, verbal delayed recall 3.13 percentile, visual delayed recall 11.00 percentile, verbal recognition <0.01 percentile, and visual recognition 13.70 percentile. Conventional brain magnetic resonance imaging did not show any abnormality. On 2-year diffusion tensor tractography for the cingulum, both anterior cingula were discontinued over the genu of the corpus callosum. One neural fiber bundle originating from the middle portion of the left cingulum descended through the left subcortical white matter, and connected to the left pedunculopontine nucleus (Ch 5) in the midbrain and the left laterodorsal tegmental nucleus (Ch 6) in the upper pons.
Reorganization of cholinergic innervations between cholinergic nuclei in the basal forebrain and brainstem following injury of the anterior cingulum was demonstrated in a patient with cerebral concussion.
我们报告了一名脑震荡患者，其受伤的扣带回与脑干胆碱能核之间出现了神经重组。
患者的主要关注点是记忆障碍。
脑震荡。
发病2年后她来我院就诊时，使用韦氏智力量表和首尔神经心理筛查量表对认知功能进行了评估：总智商97，言语即刻回忆处于第5.70百分位，视觉即刻回忆处于第30.75百分位，言语延迟回忆处于第3.13百分位，视觉延迟回忆处于第11.00百分位，言语识别<0.01百分位，视觉识别处于第13.70百分位。常规脑磁共振成像未显示任何异常。在对扣带回进行的2年弥散张量纤维束成像中，双侧前扣带回在胼胝体膝部中断。一束起源于左侧扣带回中部的神经纤维束穿过左侧皮质下白质，与中脑的左侧脑桥脚核（Ch 5）和脑桥上段的左侧背外侧被盖核（Ch 6）相连。
在一名脑震荡患者中证实了前扣带回损伤后基底前脑和脑干胆碱能核之间胆碱能神经支配的重组。
