Abstract
Early evaluation of the corticospinal tract (CST) is critical for patients with acute hypertensive intracerebral hemorrhage (ICH) to predict long-term motor functional outcome. Therefore, we investigated motor functional outcome of an ICH using diffusion tensor imaging (DTI) in patients with hypertensive ICH. Thirty six patients with hemiparesis due to hypertensive ICH underwent DTI within 3 days after onset. Fractional anisotropy (FA) was measured within the CST at levels of the posterior limbs of the internal capsules, and motor impairment was assessed on admission and 8 weeks after ICH by manual muscle test. The correlation between FA ratio and improvement of motor function was analyzed by Pearson’s correlation analysis. The FA ratio from the initial DTI showed a correlation with motor function improvement. The amount of hematoma correlated with motor function on admission, but did not show correlation with the degree of motor recovery. Therefore, FA ratio analysis calculated from FA values of DTI could be a prognostic factor of motor function improvement in patients with hypertensive ICH.
Highlights
Hypertensive intracerebral hemorrhage (ICH) may be accompanied by various degrees of motor function deficits
In patients with hypertensive ICH, Fractional anisotropy (FA) ratio that is calculated from FA values of diffusion tensor imaging (DTI) could be a prognostic factor of motor function improvement
The amount of hematoma may be related to motor function on admission, but it is not related to the degree of motor recovery
Summary
Hypertensive intracerebral hemorrhage (ICH) may be accompanied by various degrees of motor function deficits. Posterior limb of the internal capsule is frequently affected by hypertensive ICH in the BG and thalamus. Previous studies have attempted to predict motor function outcome by analyzing CST state during the early stages of ICH [1,2,3,4,5] and diffusion tensor imaging (DTI) has received increasing attention. Each of different neural fiber has different directions by which diffusion directions are affected, and it is visualized using DTI. Those different neuronal fiber directions could be analyzed using DTI and clinically it could be applied to some white mater diseases. Prediction of motor function outcome after hypertensive ICH is critical for patients and doctors. Computed tomography (CT) scan and magnetic resonance imaging (MRI) can evaluate the amount of hematoma and location of hematoma, but these techniques are difficult to determine the motor functional outcomes
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