Detection of focal cerebral injury using diffusion tensor magnetic resonance imaging in a boy with becker muscular dystrophy

Here, we report on a boy affected by both cerebral palsy and Becker muscular dystrophy (BMD). He had infrequently used his right hand since birth. But brain magnetic resonance imaging (MRI) taken at the age of 15 months showed no specific finding. Approximately 1 month later, muscle enzymes of his older brother were incidentally found to be elevated. The patient and his brother were diagnosed with progressive muscular dystrophy by gene analysis. At the age of 6 years, he underwent orthopedic surgery due to a right equinovarus deformity and BMD was confirmed by concomitant muscle biopsy. During the post-operative rehabilitation, clumsiness of the right hand was also observed. A follow-up brain MRI with diffusion tensor imaging (DTI) was taken. Although no responsible lesion was found on conventional MRI, DTI and fiber tractography revealed a decrease in the quantity of fibers in the left corticospinal tract. He was additionally diagnosed as having cerebral palsy.