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Delayed unilateral post-traumatic tremor: localization studies using single-proton computed tomographic and magnetic
1Madigan Army Medical Center, Tacoma, WA 98431, USA.
Military Medicine
|January 29, 1999
Summary
A former Marine developed a tremor years after head trauma. Advanced brain imaging revealed metabolic changes linked to the injury, suggesting a trans-synaptic origin for the movement disorder.
Area of Science:
- Neuroscience
- Neurology
- Radiology
Background:
- Head trauma can lead to delayed-onset neurological disorders.
- Movement disorders, such as dystonic tremor, can manifest years after the initial injury.
Observation:
- A 46-year-old former U.S. Marine presented with unilateral dystonic tremor.
- The tremor began 13 years after combat-induced head trauma.
- Conventional neuroimaging was normal, but advanced techniques revealed abnormalities.
Findings:
- Single-proton computed tomographic scans showed hypometabolism ipsilateral to the trauma site.
- Proton echoplanar spectral imaging indicated decreased creatine signal in the affected brain region.
- This signal normalized with anticholinergic medication, and choline imaging showed a signal void in the basal ganglia-thalamus region.
Implications:
- The findings suggest a trans-synaptic origin for the movement disorder.
- Advanced neuroimaging techniques can detect subtle metabolic changes after head trauma.
- This case highlights the potential for delayed neurological sequelae following traumatic brain injury.
