Post-traumatic intention tremor--clinical features and CT findings

Area of Science:

• Neuroscience
• Neurology
• Trauma Surgery

Background:

• Post-traumatic intention tremor is a rare but significant complication of severe head injury.
• It affects functional outcomes, particularly in young individuals.

Purpose of the Study:

• To investigate the clinical characteristics, neuroimaging findings, and potential mechanisms of post-traumatic intention tremor.
• To explore the relationship between brain injury patterns and the development of intention tremor.

Main Methods:

• Case series reporting on eight patients with post-traumatic intention tremor.
• Analysis of clinical presentation, neurological examination findings, and computed tomography (CT) scans in acute and chronic stages.
• Review of treatment outcomes (medication and stereotactic thalamotomy).

Main Results:

• Intention tremor developed as a late complication in young patients following severe head injury (Glasgow Coma Scale < 8).
• Neurological findings included initial coma and signs of midbrain lesions in the chronic stage.
• CT scans revealed acute midbrain high-density areas, cerebral swelling, or intraventricular hemorrhage, progressing to brain atrophy or ventricular enlargement.
• Patients showed improvement with medication or stereotactic thalamotomy.

Conclusions:

• Midbrain damage, potentially involving the Dentate-Rubro-thalamic system, is a key factor in post-traumatic intention tremor.
• Diffuse brain damage and shearing injuries likely contribute to the development of this condition.
• Early recognition and intervention, including surgical options, can improve functional outcomes.