J Korean Neurosurg Soc.  2004 Jun;35(6):555-559.

The Diagnosis of Motor Tract Disruption in Thalamic and Putaminal Hemorrhage using Diffusion Tensor MRI and Its Relation with Motor Recovery

• Shin CS
• Kim SH
• Jang SH
• Byun WM
• Chang CH
• Kim OL

Abstract

OBJECTIVE
The purpose of this study is to prove and quantify motor tract disruption and to correlate with motor weakness and its recovery in thalamic and putaminal hemorrhage using diffusion tensor magnetic resonance(MR) image. METHODS: We studied 24 patients with thalamic and putaminal hemorrhage with motor weakness who did not underwent surgery(hematoma volume < 25ml). We performed diffusion tensor MR image within a week, and then calculated FA(fractional anisotropy) index and FA ratio of posterior limb of internal capsule. We checked motor power of the patients at initial, 2 weeks, 1 month, 3 months and 6 months after hemorrhage. We divided patients into three groups according to FA ratio(group A: FA ratio < 50.0%, group B: FA ratio 50.0~75.0%, group C: FA ratio > 75.0%)and compared means of motor power at each time. RESULTS: The means of FA ratio were 42.5% in group A, 63.0% in group B and 88.2% in group C. The means of motor power were 1.1, 2.3 and 3.7 at initial. After 6 months the means of motor power were 3.0, 4.0 and 4.5. The group of lower FA ratio had more severe motor weakness and showed worse motor recovery clinically than the group of higher FA ratio(P < 0.01). Though patients had severe motor weakness initially, the patients with high FA ratio showed good recovery. CONCLUSION: In thalamic and putaminal hemorrhage, diffusion tensor MR image can prove the degree of motor tract damage and predict the degree of motor recovery.

Keyword

Thalamic and putaminal hemorrhage; Diffusion tensor MRI; Motor tract disruption; Motor recovery

MeSH Terms

Diagnosis*
Diffusion*
Extremities
Hemorrhage
Humans
Internal Capsule
Magnetic Resonance Imaging*
Putaminal Hemorrhage*