Which Neural Tract Plays a Major Role in Memory Impairment After Multiple Cerebral Infarcts? A Case Report

Injury to the thalamocortical tract (one in the Papez circuit) that leads to memory impairment following brain injury is very rare. In this study, we present a case of partial injury to the thalamocortical tract that causes memory impairment after concurrent thalamic and hippocampal infarct. A 20-year-old male complained of memory impairment 1 month after partial injury to the thalamocortical tract. Using a probabilistic diffusing tensor tractography, it was found that the right thalamocortical tract was thinner than the left thalamocortical tract. However, all other neural tracts including the fornix, cingulum, and mammillothalamic tract were intact on both hemispheres. Therefore, the memory impairment in this patient was considered as being due to thalamic infarct based on the observation that the fornix from hippocampal infarct was intact. This case suggests that the assessment of lesions in the neural tracts of the Papez circuit might be useful for understanding the mechanism of memory impairment following cerebral infarction.

Toluene-induced Encephalopathy: A Case Report

Toluene is one of well-known neuro-toxicants. It can readily cross the blood-brain-barrier and mainly affect the central nervous system (CNS). An inhalation is the typical route of its human exposure and show a variety of symptoms involving cerebral and cerebellar dysfunction, bronchial asthma, chemical pneumonitis, toxic hepatitis, renal tubular acidosis, intestinal obstruction, and myelo-dysplastic syndrome. In this case, toluene-inhalated showed numerous CNS and systemic symptoms. Authors performed such gait analysis, gross and fine motor evaluations, computerized neurocognitive test that we noticed the impaired results. After comprehensive rehabilitation for four weeks, patient improved as much as she could carry out the independent life, and finally discharged home. Authors report the case of toluene-induced encephalopathy in Republic of Korea for the first time.