Degeneration of an injured spinothalamic tract in a patient with mild traumatic brain injury

Brain Inj. 2016;30(8):1026-8. doi: 10.3109/02699052.2016.1146961. Epub 2016 Mar 30.

Abstract

Objectives: This study reports on a patient who developed degeneration of an injured spinothalamic tract (STT) detected on diffusion tensor tractography (DTT) following mild traumatic brain injury (TBI).

Case description: A 56-year-old female had suffered from head trauma resulting from a pedestrian car accident. The patient did not experience loss of consciousness or post-traumatic amnesia and the patient's Glasgow Coma Scale score was 15. She had begun to feel pain in her left hand and foot at ~ 7 days after onset. The characteristics and severity of pain were as follows: constant tingling and pricking sensation without allodynia or hyperalgesia (Visual Analogue Scale score: 3~4). No specific focal lesion was observed on brain and spine MRI and an electromyography study showed no evidence of peripheral nerve injury or radiculopathy. At 6 months after onset, the central pain in the left hand and foot became aggravated, with a Visual Analogue Scale score of 6.

Results: On 1-month DTT, partial tearing was observed in both STTs. In contrast, both partially torn STTs had become atrophy on 9-month DTT.

Conclusions: This study recommends further studies conducted on the prognosis (regeneration or degeneration) of injured STTs and on the effect of change of an injured STT on central pain.

Keywords: DTI; DTT; FMRIB; Functional Magnetic Resonance Imaging of the Brain; STTspinothalamic tract; Spinothalamic tract; TBI; VAS; diffusion tensor imaging; diffusion tensor tractography; head trauma; traumatic axonal injury; traumatic brain injury; visual analogue scale.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accidents, Traffic
  • Brain Concussion / diagnostic imaging
  • Brain Concussion / pathology*
  • Diffusion Tensor Imaging
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Middle Aged
  • Nerve Degeneration / diagnostic imaging
  • Nerve Degeneration / pathology*
  • Spinothalamic Tracts / diagnostic imaging
  • Spinothalamic Tracts / injuries
  • Spinothalamic Tracts / pathology*