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Injury of the ipsilateral vestibulothalamic tract in a patient with pontine hemorrhage

  • Sung Ho Jang
  • Hyeok Gyu Kwon
Letter to the Editor
  • 7 Downloads

Introduction

Pontine hemorrhage (PH), comprises less than 10% of all intracerebral hemorrhages, and causes vestibular dysfunction (dizziness or vertigo), abnormality of eye movements, ataxia, and dysarthria [1, 2, 3]. Among neurological deficits, vestibular dysfunction is mainly associated with lesions on the tegmentum of pons, and 44% of patients with tegmentum of pons lesion report dizziness or vertigo, because this region includes the vestibular nuclei (VN) [4].

The ipsilateral vestibulothalamic tract (VTT), which originates from the VN and runs to the tegmentum of pons, is involved in the conscious perception of movement and spatial orientation. Hence, injury of the VTT can be accompanied by dizziness or vertigo [5, 6, 7]. However, little is known about this area in the live human brain because of anatomical features (deep location and ambiguous identification) in conventional brain magnetic resonance imaging [6, 8]. In brain imaging tools, recent diffusion tensor tractography...

Keywords

Vestibulothalamic tract Pontine hemorrhage Diffusion tensor imaging Dizziness 

Notes

Acknowledgements

This paper was supported by RESEARCH FUND offered from Catholic University of Pusan.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

The authors declare that they acted in accordance with ethical standards laid down in the 1964 Declaration of Helsinki.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Bogousslavsky J, Caplan LR (2001) Stroke syndromes, 2nd edn. Cambridge University Press, Cambridge; New YorkCrossRefGoogle Scholar
  2. 2.
    Dziewas R, Kremer M, Ludemann P, Nabavi DG, Drager B, Ringelstein B (2003) The prognostic impact of clinical and CT parameters in patients with pontine hemorrhage. Cerebrovasc Dis 16(3):224–229.  https://doi.org/10.1159/000071120 CrossRefPubMedGoogle Scholar
  3. 3.
    Wessels T, Moller-Hartmann W, Noth J, Klotzsch C (2004) CT findings and clinical features as markers for patient outcome in primary pontine hemorrhage. AJNR Am J Neuroradiol 25(2):257–260PubMedGoogle Scholar
  4. 4.
    Kumral E, Bayulkem G, Evyapan D (2002) Clinical spectrum of pontine infarction. Clinical-MRI correlations. J Neurol 249(12):1659–1670.  https://doi.org/10.1007/s00415-002-0879-x CrossRefPubMedGoogle Scholar
  5. 5.
    Barmack NH (2003) Central vestibular system: vestibular nuclei and posterior cerebellum. Brain Res Bull 60(5–6):511–541CrossRefPubMedGoogle Scholar
  6. 6.
    Lopez C, Blanke O (2011) The thalamocortical vestibular system in animals and humans. Brain Res Rev 67(1–2):119–146.  https://doi.org/10.1016/j.brainresrev.2010.12.002 CrossRefPubMedGoogle Scholar
  7. 7.
    Wijesinghe R, Protti DA, Camp AJ (2015) Vestibular interactions in the thalamus. Front Neural Circuits 9:79.  https://doi.org/10.3389/fncir.2015.00079 CrossRefPubMedGoogle Scholar
  8. 8.
    Zwergal A, Buttner-Ennever J, Brandt T, Strupp M (2008) An ipsilateral vestibulothalamic tract adjacent to the medial lemniscus in humans. Brain 131(Pt 11):2928–2935.  https://doi.org/10.1093/brain/awn201 CrossRefPubMedGoogle Scholar
  9. 9.
    Parker GJ, Alexander DC (2005) Probabilistic anatomical connectivity derived from the microscopic persistent angular structure of cerebral tissue. Philos Trans R Soc Lond B Biol Sci 360(1457):893–902.  https://doi.org/10.1098/rstb.2005.1639 CrossRefPubMedGoogle Scholar
  10. 10.
    Behrens TE, Berg HJ, Jbabdi S, Rushworth MF, Woolrich MW (2007) Probabilistic diffusion tractography with multiple fibre orientations: what can we gain? Neuroimage 34(1):144–155.  https://doi.org/10.1016/j.neuroimage.2006.09.018 CrossRefPubMedGoogle Scholar
  11. 11.
    Jang SH, Kwon HG (2018) The ipsilateral vestibulothalamic tract in the human brain: a diffusion tensor tractography study. Transl Neurosci 9:22–25.  https://doi.org/10.1515/tnsci-2018-0005 CrossRefPubMedGoogle Scholar
  12. 12.
    Lincoln NB, Jackson JM, Adams SA (1998) Reliability and revision of the nottingham sensory assessment for stroke patients. Physiotherapy 84(8):358–365CrossRefGoogle Scholar
  13. 13.
    Smith SM, Jenkinson M, Woolrich MW, Beckmann CF, Behrens TE, Johansen-Berg H, Bannister PR, De Luca M, Drobnjak I, Flitney DE, Niazy RK, Saunders J, Vickers J, Zhang Y, De Stefano N, Brady JM, Matthews PM (2004) Advances in functional and structural MR image analysis and implementation as FSL. Neuroimage 23(Suppl 1):S208–S219.  https://doi.org/10.1016/j.neuroimage.2004.07.051 CrossRefPubMedGoogle Scholar
  14. 14.
    Naidich TP, Duvernoy HM (2009) Duvernoy’s atlas of the human brain stem and cerebellum: high-field MRI : surface anatomy, internal structure, vascularization and 3D sectional anatomy. Springer, WienGoogle Scholar
  15. 15.
    Morel A, Magnin M, Jeanmonod D (1997) Multiarchitectonic and stereotactic atlas of the human thalamus. J Comp Neurol 387(4):588–630CrossRefPubMedGoogle Scholar
  16. 16.
    Shin SC, Lim DJ, Kim SD, Cho TH, Park JY, Chung YG (2007) Primary pontine hemorrhage. An analysis of 35 cases and research in prognostic factors. Korean J Cerebrovasc Surg 9(1):41–45Google Scholar
  17. 17.
    Lancman M, Norscini J, Mesropian H, Bardeci C, Bauso T, Granillo R (1992) Tegmental pontine hemorrhages: clinical features and prognostic factors. Can J Neurol Sci 19(2):236–238PubMedGoogle Scholar
  18. 18.
    Tsunoda T, Maeshima S, Watanabe M, Nagai A, Ueno Y, Ozeki Y, Okamoto S, Mizuno S, Sonoda S (2015) Rehabilitation for a patient with hemiplegia, ataxia, and cognitive dysfunction caused by pontine hemorrhage. Case Rep Neurol 7(3):213–220.  https://doi.org/10.1159/000441617 CrossRefPubMedGoogle Scholar
  19. 19.
    Massi DG, Nyassinde J, Ndiaye MM (2016) Superior Foville syndrome due to pontine hemorrhage: a case report. Pan Afr Med J 25:215.  https://doi.org/10.11604/pamj.2016.25.215.10648 CrossRefPubMedGoogle Scholar
  20. 20.
    Suner M, Prusky GT, Carmel JB, Hill NJ (2017) Longitudinal quantification of eye-movement impairments after pontine hemorrhage. Front Neurol 8:165.  https://doi.org/10.3389/fneur.2017.00165 CrossRefPubMedGoogle Scholar
  21. 21.
    Kirsch V, Keeser D, Hergenroeder T, Erat O, Ertl-Wagner B, Brandt T, Dieterich M (2016) Structural and functional connectivity mapping of the vestibular circuitry from human brainstem to cortex. Brain Struct Funct 221(3):1291–1308.  https://doi.org/10.1007/s00429-014-0971-x CrossRefPubMedGoogle Scholar
  22. 22.
    Jang SH, Lee MY, Yeo SS, Kwon HG (2018) Structural neural connectivity of vestibular nuclei in the human brain: a diffusion tensor imaging study. Neural Regen Res 13(4):727–730CrossRefPubMedGoogle Scholar
  23. 23.
    Yamada K, Sakai K, Akazawa K, Yuen S, Nishimura T (2009) MR tractography: a review of its clinical applications. Magn Reson Med Sci 8(4):165–174CrossRefPubMedGoogle Scholar

Copyright information

© Belgian Neurological Society 2019

Authors and Affiliations

  1. 1.Department of Physical Medicine and Rehabilitation, College of MedicineYeungnam UniversityGyeongsanRepublic of Korea
  2. 2.Department of Physical Therapy, College of Health SciencesCatholic University of PusanPusanRepublic of Korea

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