Article

OBJECTIVE: To report on a patient found to have injury of the spinothalamic tract
on diffusion tensor tractography following traumatic brain injury. CASE
DESCRIPTION: A 29-year-old male patient with head trauma resulting from a
pedestrian car accident presented with pain in multiple areas (both subscapular
areas, posterior head and neck, both upper trapezius areas, and the right arm and
leg). His pain had not improved with various types of conservative management.
RESULTS: Evaluations (conventional brain magnetic resonance imaging,
electromyography, and whole spine magnetic resonance imaging), performed 2 years
after the head trauma, did not reveal any specific abnormality. Fibromyalgia and
myofascial pain syndrome were ruled out by physical examination. Injuries of the
spinothalamic tracts in both hemispheres were observed on diffusion tensor
imaging in terms of the configuration (thinning) and diffusion tensor
tractography parameters (decreased fractional anisotropy or tract volume).
CONCLUSION: Some of the pain in the trunk and extremities in this patient could
be ascribed to central pain caused by injury of both spinothalamic tracts. We
conclude that diffusion tensor tractography provides a useful means of detecting
injury of the spinothalamic tract in patients with traumatic brain injury.

Langue : ANGLAIS