• Sung Ho Jang, Jeong Pyo Seo, and Young Hyeon Kwon.
• Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University 317-1, Daemyungdong, Namku, Daegu, Republic of Korea.
• Medicine (Baltimore). 2021 Aug 6; 100 (31): e26840e26840.

RationaleWe report on a patient whose arcuate fasciculus (AF) and corticobulbar tract (CBT) recovered following an infarct in the middle cerebral artery (MCA) territory, demonstrated on serial diffusion tensor tractography (DTT).Patient ConcernsThe patient showed moderate conduction aphasia on the Western Aphasia Battery with an aphasia quotient of 46.5‰ (spontaneous speech: 35.0‰, auditory comprehension: 36.0‰, and naming: 53.1‰) at 1 month after onset. His aphasia improved with an aphasia quotient of 49‰ (spontaneous speech: 71.0‰, auditory comprehension: 52.0‰, and naming: 59.0‰) at 10 months after onset.DiagnosisA 44-year-old right-handed male patient presented with aphasia and quadriplegia, which occurred at the onset of an infarct in the left MCA territory.InterventionDiffusion tensor imaging data were acquired twice (1 month and 10 months after onset).OutcomesOn one-month DTT, the discontinuation of the left AF and severe narrowing of the right CBT were observed. However, on ten-month DTT, the left AF was connected to the opposite AF by a new tract that passed through the splenium of corpus callosum, and the right CBT had become thicker.LessonsWe believe that our results suggest a recovery mechanism of injured AF and CBT in stroke patients.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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