Double decussated ipsilateral corticospinal tract in schizencephaly.
We report a patient with left hemiparesis because of schizencephaly affecting the right precentral gyrus and describe a double decussated ipsilateral corticospinal tract detected using the multimodal brain mapping technique. In this patient, we could observe that the unaffected primary motor cortex (M1) controls both hands by functional magnetic resonance imaging and motor-evoked potential study. We were also able to visualize the corticospinal tract originating from the unaffected M1 that passed through the internal capsule and cerebral peduncle on the same side. It then crossed over twice at the brain stem level to go down to the ipsilateral spinal cord. These findings show a unique pattern of brain reorganization in the recovery from early brain injury.
Chang
Won Hyuk
WH
Department of Physical Medicine and Rehabilitation, Division for Neurorehabilitation, Stroke and Cerebrovascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul 135-710, Korea.
Kim
Young-Bum
YB
Ohn
Suk Hoon
SH
Park
Chang-Hyun
CH
Kim
Sung Tae
ST
Kim
Yun-Hee
YH
D001931:Brain Mapping; D056324:Diffusion Tensor Imaging / Q000379:methods; D004558:Electric Stimulation / Q000379:methods; D019054:Evoked Potentials, Motor / Q000502:physiology*; D007839:Functional Laterality / Q000502:physiology*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D054220:Malformations of Cortical Development / Q000150:complications / Q000473:pathology*; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D010291:Paresis / Q000209:etiology / Q000473:pathology; D011712:Pyramidal Tracts / Q000098:blood supply / Q000503:physiopathology*; D050781:Transcranial Magnetic Stimulation / Q000379:methods
D010100:Oxygen