Contrecoup injury of the prefronto-thalamic tract in a patient with mild traumatic brain injury

Rationale: We report on a patient with mild traumatic brain injury (TBI) with contrecoup injury of the prefronto-thalamic tract (PTT), as demonstrated by diffusion tensor tractography (DTT). Patient concerns: A 62-year-old female patient suffered a head trauma after falling backward. While working at a height of 85cm above the floor, she fell backward and struck the occipital area of her head on the ground. The patient experienced cognitive dysfunction and depressive mood after the head trauma. Diagnoses: The patient was diagnosed as mild TBI due to falling backward. Interventions: Clinical evaluation of her brain was performed at 2 months after onset. Outcomes: DTT at 2 months after onset revealed narrowings in the right ventrolateral and both orbitofrontal PTTs, whereas both the dorsolateral and left ventrolateral PTTs were not reconstructed. Lessons: Injuries of the PTTs associated with a contrecoup brain injury were demonstrated in a patient with mild TBI.