Reorganization of corticospinal tract in a patient with posterior limb infarct of the internal capsule

<正>Several diffusion tensor-imaging studies have demonstrated motor recovery mechanisms in stroke patients with subcortical infarct,including the corona radiata,pons,and medulla.However,studies of motor recovery mechanisms have not been reported in patients with posterior limb infarcts of the internal capsule.The present study reports on a 77-year-old man with complete paralysis of the left extremities at stroke onset.At 6 months after onset,motor function of the left extremities recovered to a nearly normal state.The 3-week diffusion tensor tractography of the affected(right) hemisphere showed that corticospinal tract discontinued below the posterior limb.In contrast,6-month diffusion tensor tractography revealed that the right corticospinal tract originated from the precentral gyrus and descended along the anterior area of the infarcted posterior limb.Motor function of the affected extremities was reorganized into the anterior area of the posterior limb infarct.