Objective We investigated the relationship between contralesional ankle weakness recovery and the corticospinal tract and corticoreticular tract in stroke patients with complete injuries of the ipsilesional corticospinal tract and corticoreticular tract. Design Thirty-six patients with complete injuries of the ipsilesional corticospinal tract and corticoreticular tract were recruited. Medical Research Council and the Functional Ambulation Category were used to determine motor function of ankle dorsiflexor and gait function. Patients were assigned into two groups: group A (poor recovery) and group B (good recovery). Fractional anisotropy, apparent diffusion coefficient, and tract volume were obtained for diffusion tensor imaging parameter. Results A total of 58.3% of patients showed good recovery of contralesional ankle dorsiflexor weakness, with remainder having poor recovery. Tract volume of the contralesional corticoreticular tract in group B was higher than that in group A ( P < 0.05); no other diffusion tensor imaging parameters were significantly different between two groups. Tract volume of the contralesional corticoreticular tract and corticospinal tract showed strong ( r = 0.521) and moderate ( r = 0.399) positive correlations with Medical Research Council score of contralesional ankle dorsiflexor, respectively ( P < 0.05). Conclusions We found that the number of fibers of the contralesional corticospinal tract and corticoreticular tract was closely related to the recovery of contralesional ankle dorsiflexor weakness in stroke patients with complete injuries of the ipsilesional corticospinal tract and corticoreticular tract. Moreover, the contralesional corticoreticular tract had a closer relationship to recovery than the contralesional corticoreticular tract.

Accurate diagnosis of the presence and severity of neural injury in patients with subarachnoid hemorrhage (SAH) is important in neurorehabilitation because it is essential for establishing appropriate therapeutic strategies and developing a prognosis. Diffusion tensor imaging has a unique advantage in the identification of microstructural white matter abnormalities which are not usually detectable on conventional brain magnetic resonance imaging. In this mini-review article, 12 diffusion tensor imaging studies on SAH-related brain injury were reviewed. These studies have demonstrated SAH-related brain injuries in various neural tracts or structures including the cingulum, fornix, hippocampus, dorsolateral prefrontal region, corticospinal tract, mamillothalamic tract, corticoreticular pathway, ascending reticular activating system, Papez circuit, optic radiation, and subcortical white matter. We believe that these reviewed studies provide information that would be helpful in science-based neurorehabilitation of patients with SAH. Furthermore, the results of these reviewed studies would also be useful for clarification of the pathophysiological mechanisms associated with SAH-related brain injury. However, considering the large number of neural tracts or neural structures in the brain, more research on SAH-related brain injury in other neural tracts or structures should be encouraged.

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