Diagnostic approach to traumatic axonal injury of the optic radiation in mild traumatic brain injury: A case report

We describe a diffusion tensor tractography(DTT)-based diagnostic approach to traumatic axonal injury(TAI) of the optic radiation(OR) in a patient who showed visual field defect following mild traumatic brain injury(TBI). A 43-year-old female patient suffered head trauma during a motor vehicle accident. After the head trauma, she noticed visual disturbance. Peripheral field defects were detected in both eyes on the Humphrey visual field test. After DTT-based reconstruction of the OR, we determined the fractional anisotropy(FA) and fiber number of each whole OR. Four regions of interest(ROIs) were placed on the ORs based on DTT configuration. The right OR showed narrowing, and the left OR revealed partial tearing in the posterior portion. The fiber number of the right OR was more than two standard deviations lower than the control mean. The FA values of the ROI 2(the narrowed area of the right OR) and ROI 3(the partially torn area of the left OR) were more than two standard deviations lower than the control mean. Our results suggest that analysis of the configuration and parameters of the OR based on three-dimensionally reconstructed DTT results is useful technique in the detection of TAI of the OR in individual patients with mild TBI. Corresponding author: Han Do Lee, MS, Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Mailing Address: Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam, University 317-1, Daemyungdong, Namku, Taegu, 705-717, Republic of Korea, Tel: 82-53-620-4098 FAX: 82-53-620-4508 e-mail: lhd890221@hanmail.net Acknowledgement This work was supported by the Medical Research Center Program (2015R1A5A2009124) through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and Future Planning Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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