Abdominal pain due to the spinothalamic tract injury in patients with mild traumatic brain injury: a case report
Abstract Background We report on a patient with a mild traumatic brain injury (TBI) who developed abdominal pain due to spinothalamic tract (STT) injuries revealed by diffusion tensor tractography (DTT). Case presentation A 53-year-old female patient suffered head trauma resulting from a backward fa...
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doaj-0b9bf8b2752f4e038de1d315cddcb8022020-11-25T02:52:10ZengBMCBMC Neurology1471-23772020-04-012011410.1186/s12883-020-01695-3Abdominal pain due to the spinothalamic tract injury in patients with mild traumatic brain injury: a case reportSung Ho Jang0Young Hyeon Kwon1Sung Jun Lee2Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University 317-1Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University 317-1Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University 317-1Abstract Background We report on a patient with a mild traumatic brain injury (TBI) who developed abdominal pain due to spinothalamic tract (STT) injuries revealed by diffusion tensor tractography (DTT). Case presentation A 53-year-old female patient suffered head trauma resulting from a backward fall. While bathing at a public bathhouse, she fell backward and struck the occipital area of her head against the floor. After the head trauma, she experienced pain in the abdomen and in both hands and feet. She underwent evaluations including conventional brain MRI, abdominal and pelvic ultrasonography, and stomach and intestine endoscopy. No abnormality was observed in her brain or abdomen. In addition, her abdominal pain had not been relieved by medical management. When she came to our hospital 4 years after the head trauma, her pain characteristics and severity were as follows: intermittent pain without allodynia or hyperalgesia; squeezing and warm creeping-like pain in the abdomen (visual analog scale score: 7); tingling pain in both hands and feet (visual analog scale score: 7). She was prescribed pregabalin and gabapentin, and her abdominal and limb pain was well-controlled at a tolerable level. On DTT 4 years after head trauma, the upper portion of the spinothalamic tracts (STTs) in both hemispheres showed partial tearing. Discussion and conclusions Injury of the STT was demonstrated by using DTT in a patient who showed abdominal pain that was refractory to medical management following mild TBI. Our results suggest that central pain due to STT injury might be suspected in patients with abdominal pain that is refractory to medical management following TBI.http://link.springer.com/article/10.1186/s12883-020-01695-3Diffusion tensor tractographySpinothalamic tractTraumatic axonal injuryHead traumaBrain injury |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Sung Ho Jang Young Hyeon Kwon Sung Jun Lee |
spellingShingle |
Sung Ho Jang Young Hyeon Kwon Sung Jun Lee Abdominal pain due to the spinothalamic tract injury in patients with mild traumatic brain injury: a case report BMC Neurology Diffusion tensor tractography Spinothalamic tract Traumatic axonal injury Head trauma Brain injury |
author_facet |
Sung Ho Jang Young Hyeon Kwon Sung Jun Lee |
author_sort |
Sung Ho Jang |
title |
Abdominal pain due to the spinothalamic tract injury in patients with mild traumatic brain injury: a case report |
title_short |
Abdominal pain due to the spinothalamic tract injury in patients with mild traumatic brain injury: a case report |
title_full |
Abdominal pain due to the spinothalamic tract injury in patients with mild traumatic brain injury: a case report |
title_fullStr |
Abdominal pain due to the spinothalamic tract injury in patients with mild traumatic brain injury: a case report |
title_full_unstemmed |
Abdominal pain due to the spinothalamic tract injury in patients with mild traumatic brain injury: a case report |
title_sort |
abdominal pain due to the spinothalamic tract injury in patients with mild traumatic brain injury: a case report |
publisher |
BMC |
series |
BMC Neurology |
issn |
1471-2377 |
publishDate |
2020-04-01 |
description |
Abstract Background We report on a patient with a mild traumatic brain injury (TBI) who developed abdominal pain due to spinothalamic tract (STT) injuries revealed by diffusion tensor tractography (DTT). Case presentation A 53-year-old female patient suffered head trauma resulting from a backward fall. While bathing at a public bathhouse, she fell backward and struck the occipital area of her head against the floor. After the head trauma, she experienced pain in the abdomen and in both hands and feet. She underwent evaluations including conventional brain MRI, abdominal and pelvic ultrasonography, and stomach and intestine endoscopy. No abnormality was observed in her brain or abdomen. In addition, her abdominal pain had not been relieved by medical management. When she came to our hospital 4 years after the head trauma, her pain characteristics and severity were as follows: intermittent pain without allodynia or hyperalgesia; squeezing and warm creeping-like pain in the abdomen (visual analog scale score: 7); tingling pain in both hands and feet (visual analog scale score: 7). She was prescribed pregabalin and gabapentin, and her abdominal and limb pain was well-controlled at a tolerable level. On DTT 4 years after head trauma, the upper portion of the spinothalamic tracts (STTs) in both hemispheres showed partial tearing. Discussion and conclusions Injury of the STT was demonstrated by using DTT in a patient who showed abdominal pain that was refractory to medical management following mild TBI. Our results suggest that central pain due to STT injury might be suspected in patients with abdominal pain that is refractory to medical management following TBI. |
topic |
Diffusion tensor tractography Spinothalamic tract Traumatic axonal injury Head trauma Brain injury |
url |
http://link.springer.com/article/10.1186/s12883-020-01695-3 |
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