Injury of the dentato-rubro-thalamic tract in a patient with intentional tremor after mild traumatic brain injury: a case report.

Abstract:

OBJECTIVES:We imaged the dentato-rubro-thalamic tract (DRTT) and cortico-ponto-cerebellar tract (CPCT) using diffusion tensor tractography (DTT) to evaluate the cortico-cerebellar-cortical circuit in a patient with tremor in both hands after mild TBI. We found bilateral DRTT injury in the DTT. METHOD:A 50-year-old male presented with action tremor in both hands 1 week after mild TBI. One month before the visit, the patient had a head injury from a fall on a bus. The patient lost consciousness for 1 min and experienced post-traumatic amnesia for approximately 5 min after the accident. His Glasgow Coma Scale score was 15. The action tremor presented with a frequency of 3 Hz in both hands. No specific lesion was observed with a conventional brain MRI. RESULTS:DTT, performed 1.5 months after TBI, showed that the right DRTT was not reconstructed and the left DRTT had thinned. However, CPCT integrity was well-preserved in both hemispheres. The tremor disappeared after oral treatment with 30 mg/day indenol. The patient's tremor would have been caused by disruption of the bilateral DRTT following mild TBI. CONCLUSION:DRTT and CPCT analysis using DTT would be useful for diagnosing abnormal movement problems, including tremor and ataxia, in patients following mild TBI.

journal_name

Brain Inj

journal_title

Brain injury

authors

Chang MC,Seo JP

doi

10.1080/02699052.2020.1802656

subject

Has Abstract

pub_date

2020-07-28 00:00:00

pages

1283-1286

issue

9

eissn

0269-9052

issn

1362-301X

journal_volume

34

pub_type

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