• Ren Fujii, Makoto Tamari, Naomichi Mizuta, Naruhito Hasui, Yuki Nonaka, Fumiaki Tamiya, Misato Horinouchi, Hiroshi Hosokawa, and Shinichiro Tanaka.
• Musashigaoka Clinical Research Center, Musashigaoka Hospital (Tanakakai Medical Corp.), Kumamoto, Japan.
• Medicine (Baltimore). 2023 Jul 28; 102 (30): e34195e34195.

RationaleCorticospinal tract (CST) and corticoreticular pathway (CRP) injury patterns (i.e., the continuity of the nerve fibers) are associated with gait disturbance in post-stroke patients. In this case series study, we examined the case of 3 patients with different CST and CRP injury patterns and analyzed the characteristics of gait disturbance in each patient.Patient ConcernsPatient 1 (P1) was a 73-year-old woman who presented with paralysis of the right upper and lower extremities due to a left lacunar infarction. Patient 2 (P2) was a 41-year-old man who presented with paralysis of the right upper and lower extremities due to a left putamen hemorrhage. Patient 3 (P3) was a 57-year-old man who presented with paralysis of the left upper and lower extremities due to a right putamen hemorrhage.DiagnosisIn P1, the CRP in the affected hemisphere was intact, but the CST was discontinuous. In P2, the CST in the affected hemisphere was intact, but the CRP was discontinuous. P3 was discontinuous in both CST and CRP in the affected hemisphere.OutcomesOver time, all 3 patients improved to the level of gait independence, but they exhibited different gait patterns. Among them, P3 showed a markedly abnormal gait pattern that included spatiotemporal gait asymmetry, lateral shift of the trunk, and hip hiking.LessonsThis case series study demonstrated that even if both the CST and CRP were injured, gait recovered to some extent (i.e., independent level-ground gait), but the abnormal gait pattern might remain remarkable.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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