title: Neural injury of the Papez circuit following hypoxic-ischemic brain injury: A case report.
abstract: BACKGROUND
  Hypoxic-ischemic brain injury (HI-BI), a result of oxygen deprivation of the brain, is accompanied by memory impairment. In this study, we report on a patient with neural injury of the Papez circuit following HI-BI, demonstrated by diffusion tensor tractography (DTT).
  
  
  RESULTS
  A 48-year-old male patient suffered spontaneous cardiopulmonary arrest and underwent cardiopulmonary resuscitation for approximately 20 minutes with the concomitant oxygen deprivation leading to HI-BI. The patient showed severe memory impairment at 10 weeks after onset: a Mini-Mental State Examination score of 11 (full score: 30, cut-off score < 24), and examination using the memory function test was not possible due to severe cognitive deficit.
  
  
  RESULTS
  On 10-week DTT, discontinuation of the fornical column was observed in both hemispheres and thinning of the thalamocingulate tract was observed in the right hemisphere and nonreconstruction in the left hemisphere.
  
  
  CONCLUSIONS
  Using DTT, neural injury of the Papez circuit was demonstrated in a patient with memory impairment following HI-BI. These results suggest that analysis of the Papez circuit using DTT could provide beneficial information by detecting injury of the Papez circuit that cannot be detected on conventional brain MRI in patients with HI-BI.
authors.affiliation: Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daemyungdong, Namku, Daegu, Republic of Korea.
authors.forename: Sung Ho
authors.initials: SH
authors.lastname: Jang
authors.forename: Hyeok Gyu
authors.initials: HG
authors.lastname: Kwon
mesh_terms: D056324:Diffusion Tensor Imaging; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000150:complications*; D008032:Limbic System / Q000000981:diagnostic imaging; D008297:Male; D008569:Memory Disorders / Q000209:etiology*; D008875:Middle Aged