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Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
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Diffusion tensor tractography in two cases of kernohan-woltman notch phenomenon
Seung-Gul Jang1, Sung-Bom Pyun1
1Department of Physical Medicine and Rehabilitation, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea.
Annals of Rehabilitation Medicine
|January 28, 2014
Summary
Kernohan-Woltman notch phenomenon (KWP) causes ipsilateral motor weakness. Diffusion tensor tractography (DTT) aids in diagnosing KWP following traumatic brain injury by visualizing corticospinal tract (CST) damage.
Area of Science:
- Neurology
- Neuroscience
- Radiology
Background:
- Kernohan-Woltman notch phenomenon (KWP) is characterized by ipsilateral motor weakness resulting from contralateral cerebral peduncle compression.
- Traumatic brain injury (TBI) can precipitate KWP, presenting diagnostic challenges.
Purpose of the Study:
- To investigate the utility of diffusion tensor tractography (DTT) in diagnosing KWP following TBI.
- To explore the relationship between DTT findings, lesion characteristics, and clinical outcomes in KWP patients.
Main Methods:
- Case report of two patients with TBI-induced KWP.
- Magnetic resonance imaging (MRI) and diffusion tensor tractography (DTT) were utilized to assess cerebral peduncle integrity and corticospinal tract (CST) continuity.
- Clinical follow-up and motor recovery assessment were performed over 15 months.
Main Results:
- In one case, DTT revealed corticospinal tract (CST) interruption at the midbrain level despite normal MRI findings, correlating with poor motor recovery.
- In the second case, abnormal cerebral peduncle signal changes and inability to reconstruct the CST on DTT were observed, with significant motor improvement.
- Follow-up DTT in the first case showed no change, consistent with persistent deficits.
Conclusions:
- Diffusion tensor tractography (DTT) is a valuable tool for detecting KWP and assessing corticospinal tract (CST) involvement after traumatic brain injury.
- The characteristics of the lesion, as visualized by DTT, may predict the clinical course and motor recovery in patients with Kernohan-Woltman notch phenomenon.
