Journal of the Korean Society of Stereotactic and Functional Neurosurgery 2015;11(1):21-25.
Published online June 30, 2015.
Prediction of Functional Outcomes After Intracerebral Hemorrhage Using Diffusion Tensor Fractional Anisotropy
Sung Hyun Noh, Joo Pyung Kim, In Bo Han
Department of Neurosurgery, Bundang CHA Medical Center, CHA University College of Medicine, Seongnam, Korea
Abstract
Objective
Hypertensive intracerebral hemorrhage (ICH) is a common type of hemorrhage. The basal ganglia, followed by the thalamus, is the most common site of bleeding in ICH. Hemiparesis or hemiplegia are the most common presenting features in the hypertensive ICH due to the corticospinal tract (CST) injury. Consequently, early assessment of the integrity of the CST is critical for predicting motor functional outcome after ICH. The aim of this study was to assess the integrity of the CST after hypertensive ICH using diffusion tensor imaging (DTI). Materials and Methods: Forty patients with hemiparesis or hemiplegia after a basal ganglia or thalamus ICH underwent DTI within 3 days of onset. The fractional anisotropy (FA) of the posterior limb of the internal capsule was measured and motor impairment was assessed on admission and 8 weeks after ICH using the manual muscle test. The relationship between the FA ratio and improvements in motor function were analyzed by Pearson's correlation analysis.
Results
The initial FA ratio was correlated with motor function improvement. However, the ICH volume was correlated with motor function on admission, but not with motor function improvement.
Conclusion
FA ratio analysis and tractography constructed from DTI may be a useful tool for predicting motor functional outcome of hypertensive ICH patients.
Key Words: Corticospinal tract, Diffusion tensor imaging Hypertension, Intracerebral hemorrhage, Magnetic resonance imaging, Fractional anisotropy, Basal ganglia.


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