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Journal of Korean Neurosurgical Society 2004;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.
Cheol Sik Shin, Seong Ho Kim, Sung Ho Jang, Woo Mok Byun, Chul Hoon Chang, Oh Lyong Kim
1Department of Neurosurgery, Colleage of Medicine, Yeungnam University, Daegu, Korea. shkim@med.yu.ac.kr
2Department of Rehabilitation Medicine, Colleage of Medicine, Yeungnam University, Daegu, Korea.
3Department of Diagnositc Radiology, Colleage of Medicine, Yeungnam University, Daegu, Korea.
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.
Key Words: Thalamic and putaminal hemorrhage; Diffusion tensor MRI; Motor tract disruption; Motor recovery
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