Regression of deep left-sided hemiparesis after kinesitherapy in a patient with severe post-traumatic destruction of the right hemisphere: a clinical case

Abstract

According to the results of brain MRI, it seemed that the motor deficit in the left limbs was irreversible due to the absence of brain tissue in the right hemisphere. This clinical case is indisputably unique and not standard and contains inexplicable changes that contradict the laws of anatomy and physiology and require further study. A young patient diagnosed with post-traumatic encephalopathy after suffering a severe open craniocerebral injury, subarachnoid hemorrhage, and intracerebral hematoma in the right hemisphere, complicated by purulent meningoencephalitis, developed severe sensorimotor aphasia, gaze paresis, left-sided plegia, hypesthesia, and hemianopsia. The patient was discharged from the hospital with a very poor prognosis. However, parents and close relatives continued to activate the patient with the help of passive and active kinesiotherapy. The result was unexpected for doctors, since the neurological sensory and motor deficit gradually partially regressed with the improvement of the cognitive brain functions. In our opinion, the regression of the neurological deficit in the absence of a morphological substrate and neurophysiological recovery in the affected hemisphere is due to the high plasticity of the brain, represented by compensatory activation and reorganization of the ipsilateral sensory and pyramidal tracts.