Injury of the Papez circuit in a patient with traumatic spinal cord injury and concomitant mild traumatic brain injury

摘要

Little is known about brain injury in concomitant mild traumatic brain injury (TBI) following traumatic spinal cord injury (TSCI). In this study, we reported on a male patient with memory impairment who showed injury of the Papez circuit following TSCI and concom-itant mild TBI. A 59-year-old male underwent posterolateral fusion on T11–L2due to an L1burst fracture after falling from a height of 10 meters. The patient had a T10incomplete lesion (American Spinal In-jury Association impairment scale C) and he complained of memory impairment, which was detected after transfer to the rehabilitation department. The patient met the criteria of mild TBI and showed memory impairment at 4 weeks after onset as follows: Wechsler Adult Intelligence Scale: 101 and the Memory Assessment Scale (global memory: 61 [1%ile ]). On 4-week diffusion tensor tractography, the entire Papez circuit including thalamocortical tract, fornix, mam-millothalamic tract, and cingulum was reconstructed in both hemi-spheres except for the left thalamocortical tract between the anterior thalamic nuclei and cingulated gyrus, and the right mammillothalam-ic tract between the mammillary body and anterior thalamic nuclei, which were thinner compared with the opposite side. In this patient, injury of the Papez circuit was related to memory impairment.