Transcallosal Ipsilateral Motor Pathway from the Unaffected Hemisphere in a Patient with Traumatic Brain Injury

초록

Purpose: We presented with a patient with traumatic brain injury who showed a transcallosal ipsilateral motor pathway fromunaffected motor cortex to affected extremities, as evaluated by diffusion tensor tractography (DTT). Methods: One patient and six age-matched normal subjects were enrolled. A 42-year-old left hemiparetic male who sufferedfrom brain injury by motor vehicle accident 9 years ago showed a leukomalactic lesion in the right corona radiata and parietotemporallobe. His left extremities were completely paralyzed initially, but recovered slowly over 2 years. At the time of theevaluation, he was able to grasp and release an object, and to walk with spastic gait pattern. DTT was performed using 1.5 Twith a Synergy-L Sensitivity Encoding head coil. DTT was obtained with termination criteria of FA <0.2 and an angle change>45°. Results: The motor tracts of the unaffected (left) hemisphere of the patient and control subjects originated from the motorcortex and descended along the known corticospinal tract without any transcallosal tract. By contrast, the tract of the affected(right) hemisphere originated from the left premotor cortex, descended through the left corona radiata, and then crossed themid-portion of the corpus callosum. The tract then descended through the known corticospinal tract pathway to the rightmedulla. Conclusion: We conclude that the transcallosal ipsilateral motor pathway from the unaffected hemisphere appeared tocontribute to the motor recovery in this patient.

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