Recovery of an injured dentato-rubro-thalamic tract in a patient with traumatic brain injury

ABSTRACT

@#Several studies have reported on injury of the dentato-rubro-thalamic tract (DRTT) in patients with various brain pathologies. However, no study on recovery of an injured DRTT has been reported so far. We report on a patient who showed recovery of an injured DRTT during a period of approximately 4 years following traumatic brain injury (TBI), which was demonstrated by follow-up diffusion tensor tractography (DTT). A 24-year-old male patient suffered a car accident. The patient lost consciousness for approximately 4 months. At the beginning of rehabilitation, the patient showed mild quadriparesis, severe resting and intentional tremor on four extremities and severe truncal ataxia. He was not able to sit independently. With rehabilitation, he showed continuous improvement, and was able to walk independently at 45 months after onset of injury. On 5-month DTT, DRTTs in both hemispheres were not reconstructed. In contrast, on 13-month DTT, the lower portion of the left DRTT was reconstructed, although the right DRTT was still not reconstructed. On 32-month DTT, the whole left DRTT was reconstructed, however, only the lower portion of the right DRTT was reconstructed. Finally, both DRTTs were reconstructed on 45-month DTT.Conclusions: Recovery of an injured DRTT was demonstrated in a patient with TBI, using DTT. We believe that evaluation of the DRTT using DTT may be helpful to monitor the progress of rehabilitation in patients with movement symptoms following TBI.