Rehabilitation Course and Specification of Dysmetria of a Patient With Ataxia,Dysmetria, and Hemiparesis After a Stroke in the Corona Radiata: A Case Presentation

We present a case of a patient with ataxia, dysmetria, and hemiparesis after a stroke in the corona radiata. The patient had an excellent clinical course with near resolution of symptoms in 2 and a half weeks and returned back to work full duty and full time a couple of weeks later. We use videos of several neurologic tests to demonstrate and characterize the dysmetria. Interestingly, a key characteristic of the dysmetria appears to be different from that seen in patients with dysmetria arising from a cerebellar, thalamic, or pontine lesion. We propose a possible neurophysiologic mechanism—damage to and redundancy of part of the corticopontine portion of the cerebellar circuit located in the corona radiata—respectively responsible for this condition and recovery. We also discuss how a simple noninvasive study of patients with ataxia and dysmetria secondary to corona radiata, thalamic, pontine, and possibly other brain lesions may be helpful in elucidating the contribution of pontocerebellar fibers and other structures to motor control.

Level of Evidence

V