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

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

Neural Regeneration Research, 2018 · DOI: 10.4103/1673-5374.224384 · Published: January 1, 2018

Spinal Cord InjuryNeuroimagingBrain Injury

Simple Explanation

This case study explores the brain injury in a patient with both traumatic spinal cord injury (TSCI) and mild traumatic brain injury (TBI). It focuses on the Papez circuit, a brain structure important for memory. The patient, who experienced a spinal cord injury after a fall, also showed signs of mild TBI and memory problems. Brain scans using a technique called diffusion tensor tractography (DTT) revealed damage to specific parts of the Papez circuit. The findings suggest that in patients with TSCI and mild TBI who have memory issues, evaluating the Papez circuit with DTT could be beneficial, especially when standard brain scans don't show any clear damage.

Study Duration
Not specified
Participants
One 59-year-old male patient
Evidence Level
Level IV; Case Report

Key Findings

  • 1
    The patient with TSCI and mild TBI showed memory impairment.
  • 2
    Diffusion tensor tractography revealed injury to the left thalamocortical tract and the right mammillothalamic tract, parts of the Papez circuit.
  • 3
    The study suggests that injury to the Papez circuit may be related to the patient's memory impairment following TSCI and mild TBI.

Research Summary

This study reports on a male patient with memory impairment who showed injury of the Papez circuit following TSCI and concomitant mild TBI. DTT revealed injury of the left thalamocortical tract and the right mammillothalamic tract in the Papez circuit. The authors conclude that evaluation of the Papez circuit using DTT would be helpful in patients with concomitant mild TBI who show memory impairment following TSCI.

Practical Implications

Diagnostic Tool

DTT can be a useful tool for identifying brain injuries in patients with TSCI and mild TBI, even when conventional MRI shows no abnormalities.

Clinical Evaluation

The Papez circuit should be evaluated in patients with TSCI, mild TBI, and memory complaints.

Pathogenetic Mechanism

Traumatic axonal injury may be the primary mechanism behind the injury of the Papez circuit in such cases.

Study Limitations

  • 1
    Single case report
  • 2
    Limitations of DTT
  • 3
    Possible underestimation due to kissing fibers or false positive fiber trajectories.

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