title: Diagnostic Challenge of Diffusion Tensor Imaging in a Patient With Hemiplegia After Traumatic Brain Injury.
abstract: A 51-year-old man showed hemiplegia on his right side after a traumatic brain injury (TBI). On initial brain computed tomography (CT) scan, an acute subdural hemorrhage in the right cerebral convexity and severe degrees of midline shifting and subfalcine herniation to the left side were evident. On follow-up brain magnetic resonance imaging (MRI), there were multiple microhemorrhages in the left parietal and occipital subcortical regions. To explain the occurrence of right hemiplegia after brain damage which dominantly on the right side of brain, we used diffusion tensor imaging (DTI) to reconstruct the corticospinal tract (CST), which showed nearly complete injury on the left CST. We also performed motor-evoked potentials, and stimulation of left motor cortex evoked no response on both sides of upper extremity. We report a case of patient with hemiplegia after TBI and elucidation of the case by DTI rather than CT and MRI.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Hye Eun
authors.identifier: 0000-0003-4903-9283
authors.initials: HE
authors.lastname: Shin
authors.affiliation: Department of Physical Medicine and Rehabilitation, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Hoon Chang
authors.identifier: 0000-0001-5333-8986
authors.initials: HC
authors.lastname: Suh
authors.affiliation: Department of Physical Medicine and Rehabilitation, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Si Hyun
authors.identifier: 0000-0003-0205-067X
authors.initials: SH
authors.lastname: Kang
authors.affiliation: Department of Physical Medicine and Rehabilitation, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Kyung Mook
authors.identifier: 0000-0002-9762-085X
authors.initials: KM
authors.lastname: Seo
authors.affiliation: Department of Physical Medicine and Rehabilitation, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Don-Kyu
authors.identifier: 0000-0001-8619-830X
authors.initials: DK
authors.lastname: Kim
authors.affiliation: Department of Neurology, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Hae-Won
authors.identifier: 0000-0001-6050-7733
authors.initials: HW
authors.lastname: Shin
keywords: Corticospinal tract; Diffusion tensor imaging; Traumatic brain injuries