title: Restoration of the ascending reticular activating system compressed by hematoma in a stroke patient.
abstract: BACKGROUND
  We report on restoration of the ascending reticular activating system (ARAS), compressed by an intracerebral hematoma and perihematomal edema following a stroke. The restoration of the ARAS was demonstrated by diffusion tensor tractography (DTT).
  
  
  METHODS
  In a 60-year-old male, a brain MRI taken at 2 weeks after the surgery showed a hematoma and perihematomal edema in the left posterolateral pons and cerebellum, which were markedly resolved on a brain MRI after 5 weeks.
  
  
  METHODS
  Intraventricular hemorrhage.
  
  
  METHODS
  Navigation-guided stereotactic drainage of a hematoma in the left cerebellum, comprehensive rehabilitative therapy, including hypersomnia medication (modafinil), physical therapy, and occupational therapy.
  
  
  RESULTS
  His hypersomnia improved significantly with rehabilitation, with no daytime hypersomnia beginning 3 weeks after the surgery. On 2-week DTT, neither the neural tract of the left lower dorsal or ventral ARAS were reconstructed, but these neural tracts were wellreconstructed on 5-week DTT.
  
  
  CONCLUSIONS
  In conclusion, restoration of nonreconstructed neural tracts of the lower ARAS with the resolution of the hematoma and perihematomal edema was demonstrated in a stroke patient, using DTT.
authors.affiliation: Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daegu, South Korea.
authors.forename: Sung Ho
authors.initials: SH
authors.lastname: Jang
authors.forename: Jeong Pyo
authors.initials: JP
authors.lastname: Seo
mesh_terms: D001929:Brain Edema / Q000209:etiology / Q000628:therapy*; D056324:Diffusion Tensor Imaging; D006970:Disorders of Excessive Somnolence / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy*; D006406:Hematoma / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000150:complications*