Hyeok Kwon1, Sung Ho Jang. 1. Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Namku, Taegu, Korea.
Abstract
OBJECTIVE: We report here on a patient with intracerebral haemorrhage (ICH), who showed unusually delayed motor recovery of the leg, which started at 6 months after ICH onset. CASE REPORT: A 53-year-old man underwent craniotomy and drainage for a right putaminal ICH. The patient presented with complete paralysis of the left extremities at ICH onset. Despite having undergone rehabilitation starting at 7 weeks after onset, the patient did not show significant motor recovery of the left extremities until 6 months after onset, when the affected left leg began to show motor recovery to the point that he was able to extend his hip and knee without gravity 7 months after onset. As a result, he was able to walk independently on an even floor 9 months after onset. RESULTS: On 6-month diffusion tensor tractography, the right corticospinal tract showed disruption with Wallerian degeneration to the pontomedullary junction. CONCLUSION: This case study highlights the extensive potential for the human brain to aid in the recovery of walking after injury. In conclusion, clinicians should attempt to determine the causes of difficulty walking when examining patients with ICH and then perform intensive rehabilitation for the recovery of walking.
OBJECTIVE: We report here on a patient with intracerebral haemorrhage (ICH), who showed unusually delayed motor recovery of the leg, which started at 6 months after ICH onset. CASE REPORT: A 53-year-old man underwent craniotomy and drainage for a right putaminal ICH. The patient presented with complete paralysis of the left extremities at ICH onset. Despite having undergone rehabilitation starting at 7 weeks after onset, the patient did not show significant motor recovery of the left extremities until 6 months after onset, when the affected left leg began to show motor recovery to the point that he was able to extend his hip and knee without gravity 7 months after onset. As a result, he was able to walk independently on an even floor 9 months after onset. RESULTS: On 6-month diffusion tensor tractography, the right corticospinal tract showed disruption with Wallerian degeneration to the pontomedullary junction. CONCLUSION: This case study highlights the extensive potential for the human brain to aid in the recovery of walking after injury. In conclusion, clinicians should attempt to determine the causes of difficulty walking when examining patients with ICH and then perform intensive rehabilitation for the recovery of walking.
Authors: Anirudh Sreekrishnan; Audrey C Leasure; Fu-Dong Shi; David Y Hwang; Joseph L Schindler; Nils H Petersen; Emily J Gilmore; Hooman Kamel; Lauren H Sansing; David M Greer; Kevin N Sheth Journal: Neurocrit Care Date: 2017-12 Impact factor: 3.210