Recovery of an Injured Corticospinal Tract in a Patient With Infarction on the Corona Radiata

  • Lee, Sook (Department of Nursing, College of Health Sciences, Dankook University) ;
  • Lim, Hyoung-Won (Department of Physical Therapy, College of Health Sciences, Dankook University) ;
  • Yeo, Sang-Seok (Department of Physical Therapy, College of Health Sciences, Dankook University)
  • Received : 2015.01.21
  • Accepted : 2015.02.11
  • Published : 2015.02.25


Purpose: Many studies have attempted to elucidate the motor recovery mechanisms of stroke. In the current study, we report on a patient with infarction who showed recovery of an injured corticospinal tract (CST), using diffusion tensor imaging (DTI). Methods: A 20-year-old male presented with severe paralysis of the left extremities following an infarction in the right corona radiate and basal ganglia. The patient showed good motor recovery as much as being able to manipulate object using his left hand and could walk independently on stairs at 9 months after onset. Results: At 1 month after onset, the right CST showed decreased fiber volume due to the partial injury at the level of the corona radiate, and no (motor evoked potential) MEP was evoked from the right hemisphere. By contrast, the results at 9 months showed increased fiber volume of the right CST and the amplitude of MEP had improved to normal range on TMS. Conclusion: These results suggest that the severely injured right CST and MEP amplitude had been recovered during 9 months. Therefore, this result has important implications for brain plasticity and brain rehabilitation in patients with infarction.


Supported by : Rural Development Administration


  1. Jorgensen HS, Nakayama H, Raaschou HO, et al. Outcome and time course of recovery in stroke. Part II: Time course of recovery. The Copenhagen Stroke Study. Arch Phys Med Rehabil. 1995;76(5):406-412.
  2. Kwelly-Hayes M, Wolf PA, Kase CS, et al. Time course of functional recovery after stroke: The framingham study. Neurorehab Neural Re. 1989; 3(2):65-70.
  3. Jang SH. The role of the corticospinal tract in motor recovery in patients with a stroke: A review. NeuroRehabilitation. 2009;24(3):285-90.
  4. Mori S, van Zijl PC. Fiber tracking: Principles and strategies - a technical review. NMR Biomed. 2002;15(7-8):468-80.
  5. Kwon HI, Hong JH, Kwon YH, et al. Neural tract injuries by penetration of foreign body: A diffusion tensor tractography study. J Kor Phys Ther. 2013;25(3):132-5.
  6. Jang WH, Lee MY, Kwon HY, et al. Transcallosal ipsilateral motor pathway from the unaffected hemisphere in a patient with traumatic brain injury. J Kor Phys Ther. 2014;26(3):216-9.
  7. Jang SH, Byun WM, Han BS, et al. Recovery of a partially damaged corticospinal tract in a patient with intracerebral hemorrhage: A diffusion tensor image study. Restor Neurol Neurosci. 2006;24(1):25-9.
  8. Jang SH, Kim SH, Cho SH, et al. Demonstration of motor recovery process in a patient with intracerebral hemorrhage. NeuroRehabilitation. 2007;22(2):141-5.
  9. Yang DS, Kim DS, Kim YH, et al. Demonstration of recovery of a severely damaged corticospinal tract: A diffusion tensor tractography and transcranial magnetic stimulation follow-up study. J Comput Assist Tomogr. 2008;32(3):418-20.
  10. Basser PJ, Pierpaoli C. Microstructural and physiological features of tissues elucidated by quantitative-diffusion-tensor MRI. J Magn Reson B. 1996;111(3):209-19.
  11. Demeurisse G, Demol O, Robaye E. Motor evaluation in vascular hemiplegia. Eur Neurol. 1980;19(6):382-9.
  12. Jang SH. Somatotopic arrangement and location of the corticospinal tract in the brainstem of the human brain. Yonsei Med J. 2011;52(4):553-7.
  13. Seo JP, Jang SH. Characteristics of corticospinal tract area according to pontine level. Yonsei Med J. 2013;54(3):785-7.
  14. Han BS, Hong JH, Hong C, et al. Location of the corticospinal tract at the corona radiata in human brain. Brain Res. 2010;1326:75-80.
  15. Kwon HG, Choi BY, Chang CH, et al. Recovery of an injured corticospinal tract during a critical period in a patient with intracerebral hemorrhage. NeuroRehabilitation. 2013;32(1):27-32.