Cho Min Kyeong, Jang Sung Ho
Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daegu, South Korea.
Front Neurol. 2020 Apr 28;11:283. doi: 10.3389/fneur.2020.00283. eCollection 2020.
Accurate diagnosis of the presence and severity of neural injury in patients with subarachnoid hemorrhage (SAH) is important in neurorehabilitation because it is essential for establishing appropriate therapeutic strategies and developing a prognosis. Diffusion tensor imaging has a unique advantage in the identification of microstructural white matter abnormalities which are not usually detectable on conventional brain magnetic resonance imaging. In this mini-review article, 12 diffusion tensor imaging studies on SAH-related brain injury were reviewed. These studies have demonstrated SAH-related brain injuries in various neural tracts or structures including the cingulum, fornix, hippocampus, dorsolateral prefrontal region, corticospinal tract, mamillothalamic tract, corticoreticular pathway, ascending reticular activating system, Papez circuit, optic radiation, and subcortical white matter. We believe that these reviewed studies provide information that would be helpful in science-based neurorehabilitation of patients with SAH. Furthermore, the results of these reviewed studies would also be useful for clarification of the pathophysiological mechanisms associated with SAH-related brain injury. However, considering the large number of neural tracts or neural structures in the brain, more research on SAH-related brain injury in other neural tracts or structures should be encouraged.
准确诊断蛛网膜下腔出血（SAH）患者神经损伤的存在及严重程度在神经康复中至关重要，因为这对于制定合适的治疗策略和预测预后必不可少。扩散张量成像在识别微观结构白质异常方面具有独特优势，而这些异常在传统脑磁共振成像中通常无法检测到。在这篇小型综述文章中，对12项关于SAH相关脑损伤的扩散张量成像研究进行了综述。这些研究已证实在包括扣带束、穹窿、海马、背外侧前额叶区域、皮质脊髓束、乳头丘脑束、皮质网状通路、上行网状激活系统、帕佩兹环路、视辐射和皮质下白质等各种神经束或结构中存在SAH相关脑损伤。我们认为，这些综述研究提供的信息将有助于对SAH患者进行基于科学的神经康复。此外，这些综述研究的结果对于阐明与SAH相关脑损伤相关的病理生理机制也将是有用的。然而，考虑到大脑中神经束或神经结构的数量众多，应鼓励对其他神经束或结构中SAH相关脑损伤进行更多研究。
