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

Abstract

Objectives: Although diffusion tensor imaging (DTI) is widely studied to assess the motor outcome after ischaemic stroke, there is paucity of data regarding outcomes of intracerebral haemorrhage (ICH). The aim of this study was to determine the DTI data from different locations along the corticospinal tract (CST) and association to motor outcome.

Methods: We prospectively recruited patients with deep ICH admitted to our hospital from November 2010 to July 2012.Diffusion tensor imaging was performed within 14 days after the onset of ICH. Fractional anisotropy (FA) was measured along the CST at corona radiata, perihaematomal oedema, cerebral peduncle and pons. Corticospinal tract integrity was classified into three types by diffusion tensor tractography (DTT): type A with preserved CST, type B with partially interrupted CST and type C with completely interrupted CST. Motor outcome was assessed by Motricity index (MI) at admission, after 1 and 3 months.

Results: Forty-eight patients were enrolled with a mean age of 62 years. The median time interval from onset of ICH to DTI study was 7 days. The patients in type C had significantly worse MI at admission (P < 0.001), after 1 month (P < 0.001) and after 3 months (P < 0.001) as compared to those with type A and type B. Lower rFA at the corona radiata was significantly correlated with poorer motor outcome at admission, after 1 month and after 3 months.

Discussion: Clinical motor outcome of ICH within 2 weeks can be identified with a statistically significant decrease in rFA at the corona radiata.

Keywords: Corticospinal tract,; Diffusion tensor imaging,; Intracerebral haemorrhage; Tractography,.