Movement disorders secondary to craniocerebral trauma

Area of Science:

• Neuroscience
• Neurology
• Neurosurgery

Background:

• Traumatic brain injury (TBI) is increasingly recognized as a cause of various movement disorders.
• Approximately 20% of severe TBI survivors develop post-traumatic movement disorders, persisting in 10% long-term.
• Kinetic cerebellar outflow tremor and dystonia are the most common persistent movement disorders post-TBI.

Purpose of the Study:

• To review the incidence and types of movement disorders following traumatic brain injury.
• To discuss the neuroanatomical correlates of these post-traumatic movement disorders.
• To examine current and emerging treatment strategies for disabling post-traumatic movement disorders.

Main Methods:

• Literature review of studies on traumatic brain injury and subsequent movement disorders.
• Analysis of reported frequencies and types of movement disorders.
• Overview of neurosurgical interventions, including deep brain stimulation.

Main Results:

• Kinetic cerebellar outflow tremor (9%) and dystonia (4%) are the most frequent persistent movement disorders after severe TBI.
• Tremor is linked to cerebellar/mesencephalic lesions, while dystonia involves basal ganglia/thalamic damage.
• The overall frequency of post-traumatic movement disorders appears to be declining due to better TBI management.

Conclusions:

• While moderate/mild TBI rarely causes persistent movement disorders, severe TBI can lead to significant long-term deficits.
• Stereotactic neurosurgery, particularly deep brain stimulation, offers effective treatment for refractory movement disorders post-TBI.
• Parkinsonism is a rare outcome of single TBI but can occur after repeated head injuries, with genetic factors potentially playing a role in Parkinson's disease risk.