title: Proximal weakness due to injury of the corticoreticular pathway in a patient with traumatic brain injury.
abstract: BACKGROUND
  The corticoreticular pathway (CRP) innervates the proximal muscles of extremities and axial muscles; therefore, it is involved in postural control and gait. We report on a patient who exhibited proximal weakness due to a CRP injury, which was evaluated using diffusion tensor tractography (DTT).
  
  
  METHODS
  A 62-year-old male patient who had been injured in a traffic accident underwent conservative management for a contusional hemorrhage in the right frontotemporal lobes, and a subdural and epidural hematoma in the right temporoparietal lobes. The patient exhibited right proximal weakness (shoulder: 3+, hip: 3+) at two weeks after onset. Findings on brain MRI revealed encephalomalactic lesions in both frontal lobes.
  
  
  RESULTS
  Findings on DTT of the left CRP showed discontinuation at the midbrain level; in contrast, the integrities of the corticospinal tract in both hemispheres were maintained from the cerebral cortex to the medulla along the known pathway of the corticospinal tract.
  
  
  CONCLUSIONS
  The proximal weakness of the right shoulder and hip observed in this patient appeared to be attributed to injury of the left CRP.
authors: Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Republic of Korea.
authors: Sang Seok
authors: SS
authors: Yeo
authors: Seong Ho
authors: SH
authors: Kim
authors: Sung Ho
authors: SH
authors: Jang
mesh_terms: D000344:Afferent Pathways / Q000473:pathology; D001930:Brain Injuries / Q000150:complications* / Q000473:pathology*; D002540:Cerebral Cortex / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000209:etiology* / Q000473:pathology / Q000534:rehabilitation; D012154:Reticular Formation / Q000473:pathology*; D050781:Transcranial Magnetic Stimulation