Weakness and Difficulty Walking After Mild TBI
The corticoreticular pathway (CRP) is known to be critical for posture and the ability to walk. Only until recently has the CRP been physically identified. Using diffusion tensor imaging (DTI), researchers mapped the CRP from the premotor cortex, through the midbrain, to the corticospinal tract. Injury to the CRP can cause weakness in the proximal muscles, and a difficulty with walking and maintaining balance.
In a recent case study, clinicians describe a 14 year old girl who had experienced a mild traumatic brain injury from a car accident. She experienced mild weakness in her limbs immediately after the car accident. After 29 days, however, the weakness became more pronounced and she had difficulty walking and maintaining balance. Although MRI and EMG tests were normal, DTI results showed injury to the CRP.
The clinicians believe that the injury to the CRP was a result of secondary traumatic axonal injury, which can occur in the weeks and months after the initial injury.
Kwon HG & Jang SH. Delayed gait disturbance due to injury of the corticoreticular pathway in a patient with mild traumatic brain injury. Brain Injury. (April 2014).