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Sustained disconnection in sensorimotor pathways results in poor motor function outcome in a term infant after severe white matter injury A case reportopen access

Authors
Son, SunhanKang, Si HyunLee, Na MiKim, Don-KyuSeo, Kyung MookRo, Hee Joon
Issue Date
Aug-2018
Publisher
LIPPINCOTT WILLIAMS & WILKINS
Keywords
corticospinal tract; development; diffusion tensor imaging; gross motor function measurement; medial lemniscus; spinothalamic tract; thalamocortical pathway
Citation
MEDICINE, v.97, no.31
Journal Title
MEDICINE
Volume
97
Number
31
URI
https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/1928
DOI
10.1097/MD.0000000000011585
ISSN
0025-7974
1536-5964
Abstract
Introduction: We report a case of an infant with severe white matter injury (WMI), which was serially evaluated using diffusion tensor imaging (DTI). Case presentation: A male infant showed decreased muscle tone and weak breathing. A brain magnetic resonance imaging (MRI) 10 days after birth (first study) revealed diffuse microhemorrhages and encephalomalacia. DTI revealed lack of reconstruction of corticospinal tract (CSTs), minimal reconstruction of medial lemniscus, and related thalamocortical pathways (MLs) from the brain stem to the internal capsule level on the left side. The spinothalamic tract and related thalamocortical pathways (STTs) were reconstructed from the brain stem to the internal capsule level bilaterally. The second study one year later showed the absence of reconstruction of CSTs, but reconstruction of MLs and STTS from the brain stem to above the internal capsule showed increased visualization. The third study 3 years later still showed the absence of CSTs reconstruction and MLs and STTs showed no changes from the second study. During this 3-year observation period, the patient showed minimal motor development, and was unable to walk independently, although Gross Motor Function Measure (GMFM) scores were slightly increased. Lessons: Sustained disconnection of major sensorimotor pathways after WMI confirmed by DTI was used to predict motor function outcome.
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의과대학 (의학부(임상-광명))
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