Pure motor monoparesis of a lower limb due to head injury: a case report

A 70-year-old woman sustained a head injury after a motor vehicle accident. Physical examination conducted on admission revealed pure motor monoparesis (PMM) and pathological reflexes in the right lower extremity. Her left lower extremity and upper extremities were intact. Computed tomography showed...

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Published inBrain and nerve = Shinkei kenkyū no shinpo Vol. 64; no. 12; p. 1427
Main Authors Ando, Kazuhiro, Maruya, Jun, Kanemaru, Yu, Nishimaki, Keiichi, Minakawa, Takashi
Format Journal Article
LanguageJapanese
Published Japan 01.12.2012
Subjects
Aged
Craniocerebral Trauma - complications
Craniocerebral Trauma - pathology
Diagnostic Imaging
Diffusion Magnetic Resonance Imaging - methods
Female
Humans
Lower Extremity - physiopathology
Paresis - diagnosis
Paresis - etiology
Paresis - pathology
Paresis - therapy
Tomography, X-Ray Computed - methods
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Summary:A 70-year-old woman sustained a head injury after a motor vehicle accident. Physical examination conducted on admission revealed pure motor monoparesis (PMM) and pathological reflexes in the right lower extremity. Her left lower extremity and upper extremities were intact. Computed tomography showed a spotty high-density lesion in the left precentral gyrus and a subgaleal hematoma in the left occipital region. Magnetic resonance imaging was performed on the next day. Fluid-attenuated inversion recovery (FLAIR) imaging demonstrated a high-intensity lesion in the left precentral gyrus, and T₂ imaging revealed a low-intensity lesion suggesting a small hemorrhage in the same area. The small hemorrhage and perifocal edema were identified on diffusion-weighted images in which low- and high-intensity lesions were observed in the anterior and posterior left precentral gyrus, respectively. Subsequent neurological examinations over 2 weeks showed improvement. We discuss the clinical presentation, diagnosis, and treatment of PMM due to head injury. We concluded that FLAIR and T₂ and diffusion-weighted imaging may be useful techniques for diagnosing PMM due to head injury.
ISSN:1881-6096