Research Reports - Severe and extensive traumatic axonal injury following minor and indirect head trauma

Brain Inj. 2017 Jan 17:1-4. doi: 10.1080/02699052.2016.1239274. [Epub ahead of

Jang SH(1), Lee HD(1).

OBJECTIVES: This study reports on a patient with mild traumatic brain injury
(TBI) who showed severe and extensive traumatic axonal injury (TAI) of various
neural tracts following minor and indirect head trauma, which was demonstrated by
diffusion tensor tractography (DTT).
CASE DESCRIPTION: A 26-year-old female patient suffered from indirect head trauma
resulting from flexion-hyperextension injury after being hit from behind by a
slowly moving car. At the time of head trauma, she felt tingling sensation on her
four extremities; however, she did not experience loss of consciousness. At 5-day
after onset, she began to experience tremor on the right leg and, subsequently,
tremor had also developed in the left leg. At 8-days after onset, she could not
even stand due to tremor of both legs and began to feel a tingling sensation on
both legs. Since ~ 2 weeks after head trauma, myoclonus had developed mainly in
the trunk. After 10-weeks after head trauma, when she started rehabilitation, she
showed mild quadriparesis (4(+)/4(+)) with severe weakness of the proximal joint
(shoulder/hip, 4(-)/4(-)), severe resting and intentional tremor, ataxic gait and
severe myoclonus.
CONCLUSIONS: Severe and extensive TAI of various neural tracts was demonstrated
in a patient with mild TBI following minor and indirect head trauma, using DTT. 

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