Affiliations: [a] Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Republic of Korea | [b] Department of Neurosurgery, College of Medicine, Yeungnam University, Republic of Korea
Correspondence:
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Address for correspondence: Sung Ho Jang, MD, Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University 317-1, Daemyungdong, Namku, Taegu, 705-717, Republic of Korea. Tel.: +82 53 620 3269; Fax: +82 53 620 3269; E-mail: strokerehab@hanmail.net
Abstract: Background:The corticoreticular pathway (CRP) innervates the proximal muscles of extremities and axial muscles; therefore, it is involved in postural control and gait. We report on a patient who exhibited proximal weakness due to a CRP injury, which was evaluated using diffusion tensor tractography (DTT). Methods:A 62-year-old male patient who had been injured in a traffic accident underwent conservative management for a contusional hemorrhage in the right frontotemporal lobes, and a subdural and epidural hematoma in the right temporoparietal lobes. The patient exhibited right proximal weakness (shoulder: 3+, hip: 3+) at two weeks after onset. Findings on brain MRI revealed encephalomalactic lesions in both frontal lobes. Results:Findings on DTT of the left CRP showed discontinuation at the midbrain level; in contrast, the integrities of the corticospinal tract in both hemispheres were maintained from the cerebral cortex to the medulla along the known pathway of the corticospinal tract. Conclusion:The proximal weakness of the right shoulder and hip observed in this patient appeared to be attributed to injury of the left CRP.
