A Mid-Brain Syndrome Following Head Injury

Kremer, M.; Wr, Russell; Ge, Smyth

doi:10.1136/jnnp.10.2.49

Cited by 68 publications

(14 citation statements)

References 5 publications

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“…1 Tremor is most common and frequently contains both postural and action/intention components. Posttraumatic tremors may have a very large amplitude, clinically resembling hemiballismus.…”

Section: Introductionmentioning

confidence: 99%

Chronic posttraumatic movement disorder alleviated by insertion of meso-diencephalic deep brain stimulating electrode

Hooper

Simpson

Whittle

2001

British Journal of Neurosurgery

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Incapacitating and drug-resistant posttraumatic movement disorders have successfully been treated by stereotactic thalamotomy. We describe the case of a young man with a posttraumatic hemiballismoid type movement disorder of the left arm, persistent for 2 years, who was selected for treatment with a thalamic deep brain stimulator. However, placement of the stimulating electrode tip at the junction of the zona incerta and subthalamic regions caused abolition of the movement disorder, and the pulse generator was not required. Reassessment over a 44-month period using multiple clinical and functional tests has confirmed continued benefit. This case adds to the reports of alleviation of movement disorders following either stereotactic thalamic mapping or placement of stimulating electrodes without macroscopic thalamic lesioning.

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“…1 Tremor is most common and frequently contains both postural and action/intention components. Posttraumatic tremors may have a very large amplitude, clinically resembling hemiballismus.…”

Section: Introductionmentioning

confidence: 99%

Chronic posttraumatic movement disorder alleviated by insertion of meso-diencephalic deep brain stimulating electrode

Hooper

Simpson

Whittle

2001

British Journal of Neurosurgery

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“…Attempts to produce rigidity by lesions, generally speaking, have not been successful and the hypertonicity reported following extensive brain stem damage is considered to be more closely related to spasticity than to Parkinson-like rigidity. Experimental ventromedial tegmental lesions in the monkey resulting in postural tremor are most often associated with hypotonicity in the corresponding limbs (Poirier, 1960;Poirier et al, 1969bPoirier et al, , 1972a, a feature also reported in patients with Parkinsonism following traumatic lesions of the midbrain ventromedial tegmental area (Kremer et al, 1947). Hypertonicity associated with tremor of the limbs has been observed in two monkeys following bilateral lesions at the level of the rostral midbrain and caudal -hypothalamus (Poirier, 1960).…”

Section: Rigidity Imentioning

confidence: 85%

Physiopathology of Experimental Parkinsonism in the Monkey

Poirier

Filion

Larochelle

et al. 1975

Can. j. neurol. sci.

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“…or superior cerebellar peduncle damage. Autopsy material from patients with the posttraumatic midbrain syndrome have repeatedly shown lesions of the dorsolateral, rostral brainstem involving the superior cerebellar peduncle (10)(11)(12)(13)(14)(15), through which these crossed, ascending dentatocortical connections pass and through which crossed, descending fibers from the dentate pass to provide input to ocular motor nuclei of the brainstem.…”

Section: Discussionmentioning

confidence: 98%

Clinical Characteristics of the Late Recovery from Posttraumatic Gait Ataxia

Kotsoris¹,

Volpe²

1987

Neurorehabilitation and Neural Repair

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We examined 75 consecutive patients with closed head trauma and found that 15 (20%) had moderate to severe gait ataxia (GA) 1-8 months after injury. Evaluation over 4 years revealed that the GA improved in six patients, and was persistent in nine others. All patients with chronic GA also displayed ocular motor abnormalities and/or large amplitude intention tremor when first and later examined. Those in whom GA disappeared never displayed eye movement abnormalities or tremor. The findings suggest that ocular motor abnormalities and/or intention tremor are poor prognostic signs for recovery from posttraumatic gait ataxia, and that posttraumatic gait ataxia without associated ocular motor or cerebellar tract injury has a better prognosis and might eventually disappear.The data suggest that damage to cerebellar outflow tracts, ocular motor nuclei, or fascicles may be irreversible whereas intrinsic cerebellar injury might be reversible.

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A Mid-Brain Syndrome Following Head Injury

Cited by 68 publications

References 5 publications

Chronic posttraumatic movement disorder alleviated by insertion of meso-diencephalic deep brain stimulating electrode

Chronic posttraumatic movement disorder alleviated by insertion of meso-diencephalic deep brain stimulating electrode

Physiopathology of Experimental Parkinsonism in the Monkey

Clinical Characteristics of the Late Recovery from Posttraumatic Gait Ataxia

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