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  4. Paraplegia caused by cerebral contusions in the bilateral precentral gyri

Paraplegia caused by cerebral contusions in the bilateral precentral gyri

Surgical Neurology International, 2016 · DOI: 10.4103/2152-7806.193726 · Published: November 9, 2016

NeurologyTraumaResearch Methodology & Design

Simple Explanation

This case report describes a rare instance of paraplegia, or paralysis of the legs, resulting from head trauma that caused contusions, or bruising, on both sides of the precentral gyrus, a region of the brain responsible for motor function. The patient, a 72-year-old man, initially presented with leg paralysis and impaired consciousness after a fall. Imaging revealed contusions in the precentral gyri, leading doctors to conclude the brain injury was causing the leg weakness. The patient underwent rehabilitation and showed improvement over time, with the brain lesions also decreasing in size on follow-up imaging. This case highlights the importance of considering brain contusions as a potential cause of paraplegia, even though it is uncommon.

Study Duration
Not specified
Participants
A 72‑year‑old man
Evidence Level
Level 4; Case Report

Key Findings

  • 1
    Cerebral contusions in the bilateral precentral gyri can cause pure motor paraplegia.
  • 2
    FLAIR MRI in the acute phase is useful for identifying precentral gyri contusions.
  • 3
    Paraplegia caused by a cerebral contusion may be misdiagnosed as a spinal concussion.

Research Summary

This case report describes a 72-year-old man who developed paraplegia due to cerebral contusions in the bilateral precentral gyri following a head injury. Initial CT and MRI scans of the spine were unremarkable, but further brain MRI revealed contusions in the precentral gyri, which are responsible for motor control of the lower extremities. The patient underwent rehabilitation and showed gradual improvement, with follow-up MRI showing a reduction in the size of the brain lesions. The authors emphasize that cerebral contusions should be considered in the differential diagnosis of paraplegia.

Practical Implications

Diagnostic Consideration

Cerebral contusions should be considered in the differential diagnosis of paraplegia, even in cases of head trauma.

Imaging Importance

FLAIR MRI in the acute phase is useful for identifying precentral gyri contusions, especially when other causes of paraplegia are ruled out.

Prognostic Awareness

The size and evolution of FLAIR MRI lesions may be related to the patient's functional prognosis and recovery potential.

Study Limitations

  • 1
    Single case report limits generalizability.
  • 2
    Lack of long-term follow-up data on patient outcomes.
  • 3
    Limited information on the specific mechanisms of recovery.

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