Ann Rehabil Med.  2019 Jun;43(3):352-354. 10.5535/arm.2019.43.3.352.

Ipsilateral Hemiparesis Following Epidural Hematoma in a Patient With Traumatic Brain Injury

• Jang SH
• Seo YS

• KMID: 2453927
• DOI: http://doi.org/10.5535/arm.2019.43.3.352

Abstract

No abstract available.

MeSH Terms

Brain Injuries*
Hematoma*
Humans
Paresis*

Figure

• 

  Fig. 1. (A) Brain computed tomography images at onset show an epidural hematoma on the left fronto-parieto-temporal lobes and subarachnoid hemorrhage. (B) Brain magnetic resonance images 5 years after onset show leukomalactic lesions in the left subcortical white matter, left cerebral peduncle, and anterior center of the mid-pons (pink arrows). (C) Diffusion tensor tractography for the corticospinal tract (CST). Both CSTs, originating from the cerebral cortex including the primary motor cortex, descend to the medullary pyramid through the normal CST pathway. However, drastic narrowing (arrows) of the right CST is observed at the lower pons level. (D) Motor-evoked potentials, obtained from both abductor pollicis brevis (APB) muscles. The motor-evoked potential obtained from the left APB showed lower amplitude and higher excitatory threshold (ET) (latency=21.0 ms, amplitude=0.7 mV, ET=80%), compared to that from the right APB (latency=19.9 ms, amplitude=2.0 mV, ET=60%).

Reference

1. Jang SH, Jang WH. Change of the corticospinal tract in the unaffected hemisphere by change of the dominant hand following stroke: a cohort study. Medicine (Baltimore). 2016; 95(6):e2620.

2. Rossini PM, Burke D, Chen R, Cohen LG, Daskalakis Z, Di Iorio R, et al. Non-invasive electrical and magnetic stimulation of the brain, spinal cord, roots and peripheral nerves: basic principles and procedures for routine clinical and research application. An updated report from an I.F.C.N. Committee. Clin Neurophysiol. 2015; 126:1071–107.

3. Yoo WK, Kim DS, Kwon YH, Jang SH. Kernohan’s notch phenomenon demonstrated by diffusion tensor imaging and transcranial magnetic stimulation. J Neurol Neurosurg Psychiatry. 2008; 79:1295–7.

4. Derakhshan I. The Kernohan-Woltman phenomenon and laterality of motor control: fresh analysis of data in the article “Incisura of the crus due to contralateral brain tumor”. J Neurol Sci. 2009; 287:296.