title: Injury of the spinothalamic tract in a patient with mild traumatic brain injury: diffusion tensor tractography study.
abstract: OBJECTIVE
  To report on a patient found to have injury of the spinothalamic tract on diffusion tensor tractography following traumatic brain injury.
  
  
  METHODS
  A 29-year-old male patient with head trauma resulting from a pedestrian car accident presented with pain in multiple areas (both subscapular areas, posterior head and neck, both upper trapezius areas, and the right arm and leg). His pain had not improved with various types of conservative management.
  
  
  RESULTS
  Evaluations (conventional brain magnetic resonance imaging, electromyography, and whole spine magnetic resonance imaging), performed 2 years after the head trauma, did not reveal any specific abnormality. Fibromyalgia and myofascial pain syndrome were ruled out by physical examination. Injuries of the spinothalamic tracts in both hemispheres were observed on diffusion tensor imaging in terms of the configuration (thinning) and diffusion tensor tractography parameters (decreased fractional anisotropy or tract volume).
  
  
  CONCLUSIONS
  Some of the pain in the trunk and extremities in this patient could be ascribed to central pain caused by injury of both spinothalamic tracts. We conclude that diffusion tensor tractography provides a useful means of detecting injury of the spinothalamic tract in patients with traumatic brain injury.
authors.affiliation: Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, , Korea.
authors.forename: Jeong Pyo
authors.initials: JP
authors.lastname: Seo
authors.forename: Sung Ho
authors.initials: SH
authors.lastname: Jang
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000150:complications* / Q000473:pathology; D056324:Diffusion Tensor Imaging; D004576:Electromyography; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010146:Pain / Q000209:etiology; D013119:Spinal Cord Injuries / Q000175:diagnosis* / Q000209:etiology*; D013133:Spinothalamic Tracts / Q000293:injuries* / Q000473:pathology*