Prediction of Functional Outcome in Acute Cerebral Hemorrhage Using Diffusion Tensor Imaging at 3T: A Prospective Study

Abstract

BACKGROUND AND PURPOSE:Early evaluation of the pyramidal tract is a prerequisite in patients with intracerebral hemorrhage (ICH) in order to decide the optimal treatment or to assess appropriate rehabilitation. The aim of this study was to evaluate and predict the neuromotor and functional outcome of an ICH by using diffusion tensor imaging (DTI) in the acute phase.

Motor outcome of deep intracerebral haemorrhage in diffusion tensor imaging: comparison of data from different locations along the corticospinal tract

“…The timing of the MRI being performed and clinical outcome evaluation are comparable with those of previously published reports, but we were able to recruit more cases than previous studies. 9,10,16 In addition, this is the first report to evaluate the relationship between the FA ratio in four different areas along the CST and motor outcomes after ICH, and the results may imply the value of microstructural change over the CST. However, further investigations are necessary to clarify the fibre change in an injured CST after ICH.…”

“…[13][14][15] Most previous studies have used only the cerebral peduncle as the ROI for FA and ADC measurements to predict motor outcomes. 9,10,16 Our study is unique in that we assessed four sites along the CST, to measure DTI indices including the corona radiata, perihaematomal oedema area, cerebral peduncle and pons. Different from previous studies, this showed that injured CST could change during the motor recovery stage among patients with ICH.…”

“…[6][7][8][9] The cerebral peduncle is distal to putamen or thalamus and reduced FA at this site is supposed to be attributed to Wallerian degeneration (WD). 10 However, in ischaemic stroke DTI study, both anterograde (WD) and retrograde degeneration occurred and were associated with poor recovery after stroke. 4 The extent and the timing of the axonal degeneration proximal or distal to the injured site may be varied, and therefore, their correlation to the motor outcome may differ.…”

Wallerian Degeneration in the Corticospinal Tract Evaluated by Diffusion Tensor Imaging Correlates with Motor Deficit 30 Days after Middle Cerebral Artery Ischemic Stroke

“…Recently, Kusano et al 29 reported that FA indexes measured in the cerebral peduncles within 2 days after intracerebral hemorrhage onset may predict functional motor outcome. In this study, a region of interestϪbased analysis of the FA of the CST in the cerebral peduncles showed that FA measured in the affected side decreased by 11% compared with the unaffected cerebral peduncle.…”

Prognosis and Recovery of Motor Function with Lesion–Symptom Mapping in Patients with Stroke

“…Clarification of the cause of motor weakness is essential for prognosis and for adoption of scientific strategies for successful rehabilitation [22][23][24][25][26]. Recovery following a stroke is typically classified into neurological recovery and functional recovery; functional recovery is influenced by the external environment, continuity of rehabilitation, and motivation, whereas neurological recovery varies according to stroke pathogenesis and lesion site [27].…”