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Changes in a cerebellar peduncle lesion in a patient with Dandy-Walker malformation A diffusion tensor imaging study

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Neural Regeneration Research 2013年第5期8卷 474-478页

作者： Ah Young Lee Sung Ho Jang Sang Seok Yeo Ensil Lee Yun Woo Cho Su Min Son Department of Physical Medicine and Rehabilitation College of Medicine Yeungnam University Department of Pediatrics College of Medicine Yeungnam University

We report a patient with severe ataxia due to Dandy-Walker malformation, who showed functional recovery over 10 months corresponding to a change in a cerebellar peduncle lesion. A 20-month-old female patient who was diagnosed with Dandy-Walker syndrome and six age- and sex-matched healthy control subjects were enrolled. The superior cerebellar peduncle, the middle cerebellar peduncle, and the inferior cerebellar peduncle were evaluated using fractional anisotropy and the apparent diffusion coefficient. The patients＇ functional ambulation category was 0 at the initial visit, but improved to 2 at the follow-up evaluation, and Berg＇s balance scale score also improved from 0 to 7. Initial diffusion tensor tractography revealed that the inferior cerebellar peduncle was not detected, that the fractional anisotropy of the superior cerebellar peduncle and middle cerebellar peduncle decreased by two standard deviations below, and that the apparent diffusion coefficient increased by two standard deviations over normal control values. However, on follow-up diffusion tensor tractography, both inferior cerebellar peduncles could be detected, and the fractional anisotropy of superior cerebellar peduncle increased to within two standard deviations of normal controls. The functional improvement in this patient appeared to correspond to changes in these cerebellar peduncles. We believe that evaluating cerebellar peduncles using diffusion tensor imaging is useful in cases when a cerebellar peduncle lesion is suspected.

关键词： neural regeneration neuroimaging Dandy-Walker malformation cerebellar peduncle ataxia cerebral palsy functional ambulation category Berg's balance scale fractional anisotropy apparent diffusion coefficient diffusion tensor tractography diffusion tensor imaging grants-supported paper photographs-containing paper neuroregeneration

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Diffusion tensor imaging for measuring recovery from cerebellar peduncle injury due to intracerebral hemorrhage: A case report

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Neural Regeneration Research 2010年第12期5卷 954-957页

作者： Ji Heon Hong Sung Ho Jang Department of Physical Medicine and Rehabilitation College of Medicine Yeungnam University

Diffusion tensor tractography （DTT） in diffusion tensor imaging （DTI） examination allows for the three-dimensional visualization of cerebellar peduncles. The present case-control study analyzed the relationship between functional recovery of intracerebral hematoma patient and cerebellar peduncle injury, as detected by DTI. The enrolled patient could not sit at 3 weeks after onset, but was able to walk independently and perform most daily activities after 4 months. The 3-week DTT images revealed that all six cerebellar peduncles were compressed by the hematoma, posterior portions of all three left cerebellar peduncles were shortened, and the left middle cerebellar peduncle was interrupted in the mid-portion. The 4-week DTT images showed that all compressed cerebellar peduncles were ameliorated, although injured posterior portions of the three left cerebellar peduncles did not recover. The fractional anisotropy value of the right inferior cerebellar peduncle increased from two standard deviations below the normal control value to within two standard deviations of the normal control value. These findings suggested that functional recovery was primarily due to decompression of compressed cerebellar peduncles, and not to recovery of injured cerebellar peduncles. DTI evaluations of cerebellar peduncles could be helpful when cerebellar peduncle injury is suspected.

关键词： diffuse tensor imaging cerebellar peduncle injury intracerebral hematoma brain injury cerebellar peduncle

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