A 50-year-old man presented with complete paralysis at the onset of a putaminal hemorrhage.
The patient presented with complete paralysis of the left upper and lower extremities (Medical Research Council:0/5).
Spontaneous intra crebral hemorrhage on putamen.
He underwent comprehensive rehabilitative therapy from 3 weeks after onset. At 3weeks after onset, he presented with severe weakness of the left extremities. The weakness of his left extremities had recovered as follows at 3 months after onset. Consequently, he was able to walk independently on an even floor.
On 3-week and 3-month diffusion tensor tractography (DTTs), the right corticospinal tract (CST) and the corticoreticulospinal tract (CRT) showed discontinuations below the lesion. On 3-month DTT, the left CST had become thinner; however, the left CRT had become thicker compared with 3-week DTT (Fig. 1).
To the best of our knowledge, this is the first study to demonstrate the activation process of the CRT in the unaffected hemisphere in relation to gait recovery from early to chronic stage of stroke.
Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Taegu, Republic of Korea.
Correspondence: Han Do Lee, Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University 317-1, Daemyungdong, Namku, Taegu, 705-717, Republic of Korea (e-mail: email@example.com).
Abbreviations: DTT = diffusion tensor tractography, CST = corticospinal tract, CRT = corticoreticulospinal tract.
This work was supported by the National Research Foundation(NRF) of Korea Grant funded by the Korean Government(MSIP) (2015R1A2A2A01004073).
The authors report no conflicts of interest.
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Received September 4, 2017
Received in revised form November 14, 2017
Accepted November 15, 2017