TY - JOUR
T1 - Decreased thalamic metabolism without thalamic magnetic resonance imaging abnormalities following shearing injury to the substantia nigra
AU - Nakamizo, Akira
AU - Inamura, Takanori
AU - Amano, Toshiyuki
AU - Inoha, Satoshi
AU - Tokuda, Kentaro
AU - Yasuda, Osamu
AU - Ikezaki, Kiyonobu
AU - Fukui, Masashi
N1 - Funding Information:
This investigation was supported by Grant (12671365) from the Ministry of Education, Japan. A part of this study was carried out at Morphology Core, Graduate School of Medical Sciences, Kyushu University.
PY - 2002/11
Y1 - 2002/11
N2 - A 36-year-old man had fallen about 8 metres. Radiographs showed a mandibular fracture, indicating rotatory force applied to the head. Fluid-attenuated inversion recovery (FLAIR) imaging showed hyperintensity in both medial temporal lobes, left medial midbrain, right midbrain including cerebral peduncle, left pulvinar, left external capsule, fornix, splenium of corpus callosum, and deep white matter of both frontal lobes. Quantitative [18F]fluorodeoxyglucose (FDG)-positron emission tomography (PET) indicated markedly suppressed glucose metabolism in the left thalamus but not markedly in the striatum. At that time the neurologic examination demonstrated complete left hemiparesis, severe rigidity of the right upper extremity, and inability to move the right hand and fingers. Levodopa at 300-600mg/day improved movement of the fingers, decreased the rigidity in the extremity, and lessened the metabolic abnormality. Diminished metabolism in the left thalamus may have contributed to symptoms. The case illustrates the usefulness of PET in disclosing symptom causing abnormalities not detected by magnetic resonance imaging.
AB - A 36-year-old man had fallen about 8 metres. Radiographs showed a mandibular fracture, indicating rotatory force applied to the head. Fluid-attenuated inversion recovery (FLAIR) imaging showed hyperintensity in both medial temporal lobes, left medial midbrain, right midbrain including cerebral peduncle, left pulvinar, left external capsule, fornix, splenium of corpus callosum, and deep white matter of both frontal lobes. Quantitative [18F]fluorodeoxyglucose (FDG)-positron emission tomography (PET) indicated markedly suppressed glucose metabolism in the left thalamus but not markedly in the striatum. At that time the neurologic examination demonstrated complete left hemiparesis, severe rigidity of the right upper extremity, and inability to move the right hand and fingers. Levodopa at 300-600mg/day improved movement of the fingers, decreased the rigidity in the extremity, and lessened the metabolic abnormality. Diminished metabolism in the left thalamus may have contributed to symptoms. The case illustrates the usefulness of PET in disclosing symptom causing abnormalities not detected by magnetic resonance imaging.
UR - http://www.scopus.com/inward/record.url?scp=0036852661&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0036852661&partnerID=8YFLogxK
U2 - 10.1054/jocn.2002.1146
DO - 10.1054/jocn.2002.1146
M3 - Article
C2 - 12604285
AN - SCOPUS:0036852661
SN - 0967-5868
VL - 9
SP - 685
EP - 688
JO - Journal of Clinical Neuroscience
JF - Journal of Clinical Neuroscience
IS - 6
ER -