title: Injury of the Arcuate Fasciculus in the Nondominant Hemisphere by Subfalcine Herniation in Patients with Intracerebral Hemorrhage : Two Case Reports and Literature Review.
abstract: Using diffusion tensor tractography (DTT), we demonstrated injury of the arcuate fasciculus (AF) in the nondominant hemisphere in two patients who showed subfalcine herniation after intracerebral hemorrhage (ICH) in the dominant hemisphere. Two patients (patient 1 and patient 2) with ICH and six age-matched control patients who have ICH on the left corona radiata and basal ganglia without subfalcine herniation were recruited for this study. DTT was performed at one month after onset in patient 1 and patient 2. AFs of both hemispheres in both patients were disrupted between Wernicke's and Broca's areas. The fractional anisotropy value and tract numbers of the right AFs in both patients were found to be more than two standard deviations lower than those of control patients. In contrast, the apparent diffusion coefficient value was more than two standard deviations higher than those of control patients. Using the configuration and parameters of DTT, we confirmed injury of the AF in the nondominant hemisphere in two patients with subfalcine herniation following ICH in the dominant hemisphere. Therefore, DTT would be a useful tool for detection of underlying injury of the AF in the nondominant hemisphere in patients with subfalcine herniation.
authors.affiliation: Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daegu, Korea.
authors.forename: Sung Ho
authors.initials: SH
authors.lastname: Jang
authors.affiliation: Department of Neurosurgery, College of Medicine, Yeungnam University, Daegu, Korea.
authors.forename: Seong Ho
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Physical Medicine and Rehabilitation, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Min Cheol
authors.initials: MC
authors.lastname: Chang
keywords: Arcuate fasciculus; Broca's aphasia; Diffusion tensor tractography; Nondominant hemisphere; Subfalcine herniation