• Sung Ho Jang, Seong Ho Kim, Hyoung Won Lim, and Sang Seok Yeo.
• From the Departments of Physical Medicine and Rehabilitation (SHJ) and Neurosurgery (SHK), College of Medicine, Yeungnam University, Taegu; and Department of Physical Therapy, College of Health Sciences, Dankook University, Cheonan-si, Chungnam, Republic of Korea (HWL, SSY).
• Am J Phys Med Rehabil. 2015 Mar 1; 94 (3): 250-3.

AbstractThe authors report on a patient with traumatic brain injury who showed recovery of an injured lower portion of the ascending reticular activating system (ARAS) between the pontine reticular formation and the thalamus. A 57-yr-old male patient experienced head trauma. After 4 mos from onset, he exhibited impaired alertness, with a score of 7 on the Glasgow Coma Scale. At 40 mos after onset, the patient had a full Glasgow Coma Scale score of 15. The lower portion of the ARAS was reconstructed using the probabilistic tractography method. On 4-mo diffusion tensor tractography, the fractional anisotropy and the tract volume of the lower portion of the right ARAS were lower by more than 2 SDs of those of control subjects. By contrast, on 40-mo diffusion tensor tractography, the fractional anisotropy and the tract volume values of the lower portion of the right ARAS were within 2 SDs of those of the control subjects. The increment fractional anisotropy and the FV value of the lower portion of the right ARAS on 40-mo diffusion tensor tractography indicated recovery of the injured lower ARAS. As a result, recovery of an injured lower portion of the ARAS in a patient with traumatic brain injury was demonstrated.

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