Article

Knowledge about recovery of an injured fornix following brain injury
is limited. We describe here a patient who showed recovery of an injured fornix
following stroke. Case report: A 57-year-old female patient underwent coiling for
a ruptured anterior communicating cerebral artery aneurysm, and conservative
management for subarachnoid and intraventricular haemorrhage. The patient showed
severe cognitive impairment 6 weeks after onset. However, her cognition showed
continuous improvement with time; based on the Mini-Mental State Examination and
the Memory Assessment Scale, her cognition was within the normal range 7 months
after onset. Results: Findings from diffusion tensor tractography at 6 weeks and
7 months showed discontinuations in both columns of the fornix. The proximal
portion of both crus also showed discontinuation on diffusion tensor tractography
at 6 weeks and 7 months; however, on 7-month diffusion tensor tractography, the
end of the fornical body was shown to be connected to the splenium of the corpus
callosum and then branched to the right medial temporal lobe and right thalamus.
Conclusion: The unusual neural connection between the injured fornix and the
thalamus appears to be a recovery phenomenon, which allows the injured fornix and
the medial temporal lobe to obtain cholinergic innervation from cholinergic
nuclei in the brainstem rather than from cholinergic nuclei in the basal
forebrain.

Langue : ANGLAIS