title: Traumatic thalamic injury demonstrated by diffusion tensor tractography of the spinothalamic pathway.
abstract: BACKGROUND
  This study reports on a patient with traumatic brain injury (TBI) with a thalamic lesion in the ventroposterolateral nucleus which was demonstrated by diffusion tensor tractography (DTT) for the spinothalamic tract and its thalamocortical pathway (STP).
  
  
  METHODS
  One patient with TBI and eight normal control subjects were recruited. A 64-year-old woman who had suffered a motor vehicle accident presented with a persisting tingling sensation and pain in her right upper and lower extremities at 3 weeks after onset. The patient showed impaired touch sensation, but normal proprioception. Diffusion tensor imaging was performed at 1 month after onset. Fractional anisotropy (FA) and mean diffusivity were measured using a region of interest method along the STP.
  
  
  RESULTS
  DTT showed normal STP integrities as compared with normal controls. However, the FA values of the left STP at the thalamus were more than 2 SD decreased. The diminished FA value of the left STP in the left thalamus seems to indicate injury of the left ventrolateroposterior nucleus. Central pain and impaired touch sensation of right extremities supports the presence of left STP injury at the ventroposterolateral nucleus in this patient.
  
  
  CONCLUSIONS
  It is believed that DTT for the STP provides a useful means of detecting thalamic injury in TBI.
authors.affiliation: Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University , Taegu , Republic of Korea.
authors.forename: Jeong Pyo
authors.initials: JP
authors.lastname: Seo
authors.forename: Sung Ho
authors.initials: SH
authors.lastname: Jang
mesh_terms: D001930:Brain Injuries / Q000150:complications / Q000503:physiopathology*; D056324:Diffusion Tensor Imaging / Q000379:methods; D005260:Female; D006801:Humans; D008569:Memory Disorders / Q000175:diagnosis* / Q000209:etiology; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis* / Q000209:etiology; D010554:Personality Disorders / Q000175:diagnosis* / Q000209:etiology; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D013133:Spinothalamic Tracts / Q000503:physiopathology; D013788:Thalamus / Q000293:injuries / Q000503:physiopathology*