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Diagnostic Approach to Traumatic Axonal Injury of the Optic Radiation in Mild Traumatic Brain Injury

Jang, Sung Ho MD; Lee, Han Do MS

American Journal of Physical Medicine & Rehabilitation: August 2019 - Volume 98 - Issue 8 - p e92–e96
doi: 10.1097/PHM.0000000000001078
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We describe a diffusion tensor tractography–based diagnostic approach to traumatic axonal injury of the optic radiation in a patient who showed visual field defect after mild traumatic brain injury. A 43-yr-old female patient experienced head trauma during a motor vehicle accident. After the head trauma, she noticed visual disturbance. Peripheral field defects were detected in both eyes on the Humphrey visual field test. After diffusion tensor tractography–based reconstruction of the optic radiation, We determined the fractional anisotropy and fiber number of each whole optic radiation. Four regions of interest were placed on the optic radiations based on diffusion tensor tractography configuration. The right optic radiation showed narrowing, and the left optic radiation revealed partial tearing in the posterior portion. The fiber number of the right optic radiation was more than two standard deviations lower than the control mean. The fractional anisotropy values of the regions of interest 2 (the narrowed area of the right optic radiation) and regions of interest 3 (the partially torn area of the left optic radiation) were more than two standard deviations lower than the control mean. Our results suggest that analysis of the configuration and parameters of the optic radiation based on three-dimensionally reconstructed diffusion tensor tractography results is a useful technique in the detection of traumatic axonal injury of the optic radiation in individual patients with mild traumatic brain injury.

From the Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Taegu, Republic of Korea.

All correspondence should be addressed to: Han Do Lee, MS, Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, 317-1, Daemyungdong, Namku, Taegu, 705-717, Republic of Korea.

This work was supported by the Medical Research Center Program (2015R1A5A2009124) through the National Research Foundation of Korea funded by the Ministry of Science, ICT and Future Planning.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

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Online date: , 2019

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