Decreased thalamic metabolism without thalamic magnetic resonance imaging abnormalities following shearing injury to the substantia nigra

Akira Nakamizo, Takanori Inamura, Toshiyuki Amano, Satoshi Inoha, Kentaro Tokuda, Osamu Yasuda, Kiyonobu Ikezaki, Masashi Fukui

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)685-688
Number of pages4
JournalJournal of Clinical Neuroscience
Volume9
Issue number6
DOIs
Publication statusPublished - Nov 2002

All Science Journal Classification (ASJC) codes

  • Surgery
  • Neurology
  • Clinical Neurology
  • Physiology (medical)

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