title: Recovery of injured lower portion of the ascending reticular activating system in a patient with traumatic brain injury.
abstract: The authors report on a patient with traumatic brain injury who showed recovery of an injured lower portion of the ascending reticular activating system (ARAS) between the pontine reticular formation and the thalamus. A 57-yr-old male patient experienced head trauma. After 4 mos from onset, he exhibited impaired alertness, with a score of 7 on the Glasgow Coma Scale. At 40 mos after onset, the patient had a full Glasgow Coma Scale score of 15. The lower portion of the ARAS was reconstructed using the probabilistic tractography method. On 4-mo diffusion tensor tractography, the fractional anisotropy and the tract volume of the lower portion of the right ARAS were lower by more than 2 SDs of those of control subjects. By contrast, on 40-mo diffusion tensor tractography, the fractional anisotropy and the tract volume values of the lower portion of the right ARAS were within 2 SDs of those of the control subjects. The increment fractional anisotropy and the FV value of the lower portion of the right ARAS on 40-mo diffusion tensor tractography indicated recovery of the injured lower ARAS. As a result, recovery of an injured lower portion of the ARAS in a patient with traumatic brain injury was demonstrated.
authors.affiliation: From the Departments of Physical Medicine and Rehabilitation (SHJ) and Neurosurgery (SHK), College of Medicine, Yeungnam University, Taegu; and Department of Physical Therapy, College of Health Sciences, Dankook University, Cheonan-si, Chungnam, Republic of Korea (HWL, SSY).
authors.forename: Sung Ho
authors.initials: SH
authors.lastname: Jang
authors.forename: Seong Ho
authors.initials: SH
authors.lastname: Kim
authors.forename: Hyoung Won
authors.initials: HW
authors.lastname: Lim
authors.forename: Sang Seok
authors.initials: SS
authors.lastname: Yeo
mesh_terms: D001930:Brain Injuries / Q000175:diagnosis / Q000473:pathology / Q000534:rehabilitation*; D056324:Diffusion Tensor Imaging; D015600:Glasgow Coma Scale; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D065821:Pontine Tegmentum / Q000293:injuries / Q000473:pathology; D020127:Recovery of Function; D012154:Reticular Formation / Q000293:injuries* / Q000473:pathology